摘要
目的:探讨七氟烷麻醉对急性创伤性颅脑损伤患者围手术期炎症介质表达、神经功能损害及患者预后的影响。方法:收集2015年7月至2016年12月急诊开颅手术的创伤性颅脑损伤患者80例,随机分为试验组(七氟烷处理组)和对照组,各40例。围手术期抽取外周血,利用酶联免疫吸附测定法检测血清中TNF-α、IL-6、CRP蛋白和NSE浓度,比较两组患者GCS评分、APACHEⅡ评分和预后。结果:与对照组比较,试验组在术中1 h、术毕和术后第1天血清炎症介质(CRP、TNF-α、IL-6)表达明显降低(P<0.05或0.01),神经元特异性烯醇化酶NSE蛋白在术毕及术后第1天表达降低(P<0.05或0.01);七氟烷处理有效改善患者病情,在第14天GCS评分[(10.82±1.40)比(8.29±1.02),P=0.03],APACHEⅡ评分[(14.42±1.97)比(18.03±2.15),P=0.02]。结论:七氟烷处理可通过抑制创伤性颅脑损伤患者围手术期伤后炎症反应,减少神经元细胞损害,起到神经保护作用和改善患者预后。
Objective： To investigate the effects of Sevoflurane on inflammatory response,neuro damage and the prognosis on surgery patients with traumatic brain injury（ TBI）. Methods： From July 2015 to December 2016,80 TBI patients undergoing neurosurgery were randomly divided into experimental group（ Sevoflurane treatment,n = 40） and control group（ n = 40）. The serum levels of TNF-α,IL-6,C-reactive protein（ CRP） and neuron specific enolase（ NSE） were tested with enzyme linked immunosorbent Assay（ ELISA）. GCS score,APACHEⅡ score and prognosises of the two groups were also compared. Results： Compared with control group,the serum levels of inflammatory related factors（ CRP,TNF-α,IL-6） in the experimental group were significantly decreased in 1hour of intraoperative,at the end of surgery and on 1st day after surgery respectively（ P〈0. 05 or 0. 01）. Meanwhile,NSE protein expressions were significantly decreased（ P〈0. 05 or 0. 01）. The experimental group received better prognosis compared to the control group,GCS scores[（ 10. 82±1. 40） vs（ 8. 29±1. 02）,P = 0. 03],APACHEⅡ scores[（ 14. 42±1. 97） vs（ 18. 03±2. 15）,P = 0. 02]on the 14 th day. Conclusion： Sevoflurane treatment can effectively regulate the inflammatory response,reduce the neurons damage in surgery patients with TBI,possibly playing brain protection effect.
出处
《中国免疫学杂志》
CAS
CSCD
北大核心
2017年第10期1537-1540,1543,1544,共6页
Chinese Journal of Immunology
基金
福建省自然科学基金项目(No.J[2015]01383)
关键词
创伤性颅脑损伤
七氟烷
炎症反应
神经保护
Traumatic brain injury
Sevoflurane
Inflammatory response
Neuroprotection
