重度颅脑损伤患者术后应用重组人促红细胞生成素对血清VEGF、NSE水平及脑血管痉挛的影响

目的 探讨重度颅脑损伤患者术后应用重组人促红细胞生成素(r-HuEPO)对血清血管内皮因子(VEGF)、神经元特异性烯醇化酶(NSE)水平及脑血管痉挛的影响。方法将86例重度颅脑损伤患者分为对照组与观察组各43例,两组均接受手术治疗,术后对照组予常规治疗,观察组应用r-HuEPO治疗。比较两组患者治疗前后外周血VEGF、NSE、S100B蛋白(S-100B)水平及格拉斯哥昏迷指数评分(GCS)及格拉斯哥预后评分(GOS)的变化,并采用经颅多普勒超声(TCD)监测患者脑血流,统计脑血管痉挛发生率。结果治疗2周,两组NSE、VEGF、S-100B水平及大脑前动脉(ACA)、大脑中动脉(MCA)、大脑后动脉(PCA)、基底动脉(BA)、椎动脉(VA)血流速率均降低,观察组降低幅度高于对照组(P<0.05)。治疗2周,两组GCS、GOS评分均上升,观察组上升幅度高于对照组(P<0.05)。观察组术后脑血管痉挛发生率低于对照组(P<0.05)。结论重度颅脑损伤患者术后采用r-HuEPO干预,可下调NSE、VEGF、S-100β蛋白表达,减轻脑血管损伤程度,降低脑血管痉挛发生率。

Effect of recombinant human erythropoietin on serum VEGF,NSE levels and cerebral vasospasm in patients with severe craniocerebral injury after operation

Objective To explore the effect of recombinant human erythropoietin (r-HuEPO) on serum vascular endothelial growth factor (VEGF),neuron specific enolase (NSE) levels and cerebral vasospasm in patients with severe craniocerebral injury after operation.MethodsEighty-six patients with severe craniocerebral injury were divided into the control group and the observation group with 43 cases in each group.After operation,the control group received routine treatment,while the observation group was treated with r-HuEPO.The changes of peripheral blood VEGF,NSE and S100B protein (S-100B) levels,Glasgow coma score (GCS) and Glasgow outcome score (GOS) before and after treatment were compared between the two groups.The cerebral blood flow was monitored by transcranial Doppler ultrasound (TCD),and the incidence of cerebral vasospasm was statistically analyzed.ResultsAfter 2 weeks of treatment,NSE,VEGF and S-100B levels,the anterior cerebral artery (ACA),middle cerebral artery (MCA),posterior cerebral artery (PCA),basilar artery (BA) and vertebral artery (VA) blood flow rate were decreased,and the decreased range in observation group was higher than that in the control group (P<0.05).After 2 weeks of treatment,GCS and GOS scores were increased,and the increased range in observation group was higher than that in the control group (P<0.05).The incidence rate of cerebral vasospasm in the observation group after operation was lower than that in the control group (P<0.05).ConclusionThe application of r-HuEPO intervention can downregulate the expression of NSE,VEGF and S-100 protein,reduce the degree of cerebral vascular injury and reduce the incidence of cerebral vasospasm in patients with craniocerebral injury.