摘要
目的观察急性重型颅脑损伤(asTBI)后血清S100B浓度的变化及其与预后的关系,研究硫酸镁对asTBI患者血清S100B浓度和预后的影响。方法69例患者随机分为硫酸镁治疗组(n=34)和常规治疗对照组(n=35)。按入院时GCS评分分为特重组(GCS3～5分)和重型组(GCS6～8分),于入院时,伤后1、4、7、14天,检测血清镁、S100B浓度和GCS评分。治疗组首剂给予25%硫酸镁16ml静脉滴注,15分钟输完,继予25%硫酸镁60ml静脉滴注,匀速24h输完。对照组除未用硫酸镁外其余治疗与治疗组完全相同。伤后3个月时纪录GOS评分。结果与健康对照组比较,asTBI后血清镁离子浓度下降(P<0.05),血清S100B浓度升高,特重组(ssTBI)S100B浓度高于重型组(sTBI)(P<0.05)。伤后第4、7天,治疗组血清S100B浓度低于对照组(P<0.05)。入院时血清S100B浓度高于1.2μg/L者预后不良,其敏感度为(sensitivity,SEN)为75.8%,特异度(specificity,SPE)为69.4%。治疗组与对照组预后的比较无统计学意义(P>0.05)。结论asTBI后,血清镁离子浓度下降,血清S100B浓度升高,且伤情越重,血清S100B浓度越高,预后越差。早期应用硫酸镁提高asTBI患者血清镁离子浓度可降低伤后第4、7天血清S100B浓度,提示硫酸镁具有一定的神经保护作用,但并不能改善预后。
Objective To observe the changes of serum S100B and its relationship with outcome in the patients with acute severe traumatic brain injury（asTBI）. To studay the effects of magnesium sulfate （MgSO4 ） on outcome and serum SIOOB in the patients with asT- BI. Methods 69 cases of the patients with asTBI were randomly divided into treatment group （ n = 34） and control group （ n = 35 ）. All cases were subdivided into sTBI group（ GCS 6 -8 分） and special severe traumatic brain injury（ssTBI） group（ GCS 3 -5 分） according to the Glasgow Coma Scale score （GCSs） at admission. Serum Mg2＋ and SIOOB were monitored at admission, 1 day, 4 days, 7 days and 14 days after injury, and the GCSs were recorded at the same time. The patients in treatment group received intravenous Mg- SO4, which was initiated with 16ml of 25% MgSO4 over 15 minutes, followed by continuous infusion of 60ml for 24 hours. Patients with control group were only treated with common methods without MgSO4. The Glasgow Outcome Scale score （GOSs） were recorded at 3 mouths after injury. Results Decreased serum Mg^2＋ were observed in the patients with asTBI compared to healthy people （ P 〈 0.05 ）. Increased serum SIOOB were observed in the patients with ssTBI group compared to sTBI group and control group compared to treatment group at 4 and 7 days after injury （ P 〈 0.05 ）. But there was no significantly better outcome in treatment group compared to control group. The patients＇serum SIOOB with less than 1.2 μg/L recovered very well. The sensitivity of serum S100B was 75.8% and specificity 69.4%. Conclusions In the patients with asTBI, the serum Mg^2＋ decreased, and the severer TBI is,higher serum S100B and lower GOS score are. Intravenous MgSO4 at the early phase of asTBI to increase serum Mg^2＋ can reduce serum S100B at 4 and 7 days after injury, it have the neuroprotective function but the outcome couldn＇t be improved.
出处
《国际神经病学神经外科学杂志》
2009年第3期197-200,共4页
Journal of International Neurology and Neurosurgery
关键词
硫酸镁
颅脑损伤
S100B
预后
magnesium sulfate
brain injury
SIOOB
outcome
neuroprotection
