DOI:10.16636/j.cnki.jinn.2014.02.006 Journal of International Neurology and Neurosurgery 1 2 2 1. 410004 2. 410008 β- β-ep DynA1-13 NSE 40 20 1 2 3 5 7 10 β-ep DynA1-13 NSE 3 GOS β-ep DynA1-13 NSE β-ep DynA1-13 NSE P < 0. 05 P > 0. 05 GOS β-ep DynA1-13 NSE β- A1-13 Clinical trial of brain-protective effect of nalmefene hydrochloride in patients with acute traumatic brain injury Wang Hong-Xin 1 Liu Zhi-Xiong 2 Liu Jin-Fang 2 1. Neurosurgery department Changsha Central Hospital Hunan Changsha 410004 2. Neurosurgery department Xiangya Hospital Central South University Hunan Changsha 410008. Abstract Objective To study the changes in serum β-endorphin β-ep dynorphin DynA1-13 and neuron-specific enolase NSE in patients with acute traumatic brain injury TBI after treatment with nalmefene hydrochloride and to evaluate the brain-protective effect and adverse reactions of nalmefene hydrochloride in TBI patients. Methods Forty patients with acute TBI were randomly divided into nalmefene hydrochloride treatment group n = 20 and control group n = 20. The patients in control group received conventional treatment while those in nalmefene hydrochloride treatment group were given nalmefene hydrochloride in addition to the conventional treatment. Serum levels of β-ep DynA1-13 and NSE were measured before treatment and on days 1 2 3 5 7 and 10 of treatment in all patients meanwhile the heart rate respiratory rate and medication-related adverse events were recorded. Glasgow Outcome Scale GOS scores were compared between the two groups after three months. Results Serum levels of β-ep DynA1-13 and NSE were significantly lower in the treatment group than in the control group. The three indices showed an overall decreasing trend in the treatment group serum β-ep and DynA1-13 showed an overall increasing trend in the control group while serum NSE showed an overall decreasing trend. The treatment group had significantly lower proportions of individuals with abnormal heart rate and abnormal respiratory rate than the control group P < 0. 05. The incidence of medication-related adverse events showed no significant difference between the two groups P > 0. 05 while GOS scores showed a significant difference between the two groups. Conclusions For 2014-01 - 20 2014-04 - 18 1985-1971 - 1969-110
2 014 4 1 2 patients with acute TBI nalmefene hydrochloride can reduce serum β-ep DynA1-13 and NSE and the secondary pathological damage exert a certain brain-protective effect reduce the abnormalities of heart rate and respiratory rate and improve prognosis and it causes little adverse reactions. Key words Nalmefene hydrochloride Traumatic brain injury β-ep DynA1-13 NSE 1-3 43. 45 ± 14. 06 GCS 8. 20 ± 1. 67 10 10 15 5 42. 15 ± 4-7 10. 62 GCS 8. 45 ± 1. 99 12 8 2 40 20 0. 2 mg / β -EP DynA1-13 2 12 h 10 NSE 1 2 3 5 7 10 1 β -EP DynA1-13 NSE 1. 1 2012 3 2013 3 3 40 GOS 12 ~ 24 / 31 9 21 ~ 76 60 ~ 100 / 42. 80 ± 12. 32 29 8 3 CT 25 15 32 9 SPSS 19. 0 14 17 ± x 珋 ± 22 18 1. 2 1 2 24 h GCS 12 CT 3 B CT GCS 4 5 1. 3 40 1 2 20 16 4 111 8 2 ml s t P < 0. 05 3 3. 1 3. 2 β-ep DynA1-13 NSE 3 5 7 10 β -
Journal of International Neurology and Neurosurgery EP DynA1-13 NSE 3. 3 β -EP DynA1-13 5 β -EP DynA1-13 5 4 NSE 1 8 12 7 13 13 7 5 15 5 14 6 12 8 P P < 0. 05 P < 0. 05 P > 0. 05 NSE P < 1 β-ep pg /ml 223. 91 ± 16. 86 220. 71 ± 15. 52 P > 0. 05 1 211. 12 ± 16. 66 231. 70 ± 16. 10 P < 0. 05 2 196. 72 ± 18. 53 244. 67 ± 18. 30 P < 0. 05 3 192. 40 ± 15. 11 255. 42 ± 16. 43 P < 0. 05 5 202. 87 ± 16. 80 266. 93 ± 13. 77 P < 0. 05 7 180. 33 ± 15. 36 259. 58 ± 14. 79 P < 0. 05 2 DynA1-13 pg /ml 188. 85 ± 14. 59 182. 68 ± 15. 41 P > 0. 05 1 182. 46 ± 16. 19 196. 53 ± 16. 26 P < 0. 05 2 175. 20 ± 18. 32 210. 34 ± 16. 41 P < 0. 05 3 146. 33 ± 12. 83 222. 23 ± 17. 06 P < 0. 05 5 171. 12 ± 16. 59 248. 59 ± 16. 70 P < 0. 05 7 160. 02 ± 17. 82 228. 48 ± 17. 46 P < 0. 05 10 119. 15 ± 20. 46 204. 99 ± 16. 82 P < 0. 05 DynA1-13 P > 0. 05 DynA1-13 P < 0. 05 3 NSE ng /ml 27. 11 ± 8. 02 27. 15 ± 7. 39 P > 0. 05 1 21. 42 ± 4. 98 25. 20 ± 6. 51 P < 0. 05 2 17. 65 ± 5. 00 22. 22 ± 7. 30 P < 0. 05 3 15. 65 ± 4. 85 19. 59 ± 6. 70 P < 0. 05 5 19. 83 ± 5. 57 24. 76 ± 6. 72 P < 0. 05 7 18. 04 ± 4. 61 22. 61 ± 5. 67 P < 0. 05 10 14. 64 ± 3. 91 20. 24 ± 5. 36 P < 0. 05 0. 05 P > 0. 05 3. 4 3 GOS NSE P > 0. 05 α β γ NSE P < 0. 05 αα αβ 5 3 GOS GOS 20 4. 10 ± 1. 02 20 3. 35 ± 1. 27 GOS p < 0. 05 10 151. 27 ± 15. 37 246. 59 ± 13. 30 P < 0. 05 4 β-ep P > 0. 05 β-ep P < 0. 05 112 8-10 11 12
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