摘要
目的观察不同剂量乌司他丁对大面积脑梗死患者转化生长因子β1(transforming growth factorβ1,TGF-β1)和预后的影响。方法 74例脑大面积脑梗死患者随机分为3组,A组22例,进行重症监护、甘露醇脱水降颅压、抗血小板聚集、开颅手术、营养神经、抗感染、营养支持等综合治疗; B组27例,在此治疗基础上加用乌司他丁20万U/d治疗; C组25例,在此治疗基础上加用乌司他丁40万U/d治疗,观察3组患者治疗前和治疗10 d、20 d的TGF-β1水平差异,以及住院8周内的病死率。结果3组患者在治疗前TGF-β1水平无统计学差异,经过治疗10 d和20 d后,A组患者TGF-β1水平无明显改变,B组和C组有不同程度升高,且C组升高更多,差异均有统计学意义(P<0. 05)。住院期间3组患者病死率无明显差异。结论乌司他丁能够提高大面积脑梗死患者的TGF-β1水平,且提高程度与剂量有关,但不能改善预后。
Objective To observe the effects of different doses of ulinastatin on transforming growth factorβ1(TGFβ1)and prognosis in patients with large area cerebral infarction.Methods Seventy four patients with large brain cerebral infarction were randomly divided into 3 groups,22 patients in group A,for intensive care,mannitol dehydration and intracranial pressure,antiplatelet aggregation,craniotomy,nutritional nerve,anti infection,nutritional support and other comprehensive treatment.In group B,27 patients were treated with ulinastatin 200,000 U/d.25 patients in group C,ulinastatin 400,000 U/d was added on the basis of this treatment.The difference in TGFβ1 levels before and 10 days and 20 days after treatment,and the mortality rate within 8 weeks of hospitalization were observed.Results There were no significant differences in TGFβ1 levels between the three groups.After treatment for 10 days and 20 days,there was no significant change in TGFβ1 levels in group A,and increased in groups B and C in different degrees,and the group C increased more and the difference was statistically significant.There was no significant difference in mortality among the three groups during hospitalization.Conclusion Ulinastatin can increase the level of TGFβ1 in patients with large area cerebral infarction,and the degree of improvement is related to the dose,but it can not improve the prognosis.
作者
苏建
刘辉
耿海威
于荣焕
SU Jian;LIU Hui;GENG Haiwei;YU Ronghuan(Department of Neurology,Zhengzhou Second People's Hospital,Zhengzhou 450000,China;Kaifeng Central Hospital,Kaifeng 475000,China)
出处
《中国实用神经疾病杂志》
2018年第22期2494-2499,共6页
Chinese Journal of Practical Nervous Diseases
