1,6二磷酸果糖对颅脑损伤炎症介质浓度影响和预后观察.docVIP

1,6-二磷酸果糖对颅脑损伤炎症介质浓度的影响和预后观察 　　【摘要】 目的 观察1,6-二磷酸果糖(FDP)对重度颅脑创伤患者炎症介质浓度变化及预后的影响。方法 选择2008年4月~2010年6月入住笔者所在医院ICU的急性重症颅脑创伤患者100例，随机分为两组，两组均按常规重型颅脑创伤治疗原则处理，治疗组（50例）入院当日给予1,6-二磷酸果糖（FDP）10 g/d，静脉点滴，对照组（50例）按常规重型颅脑创伤治疗原则处理。两组入院1、3、5、7 d 分别检测脑引流液和血清肿瘤坏死因子-?（TNF-?）、白细胞介素-1β（IL-1β）、IL-6、IL-10的浓度。统计两组患者GCS评分、APACHE Ⅱ评分、入住ICU时间、呼吸机使用时间及死亡率。结果 两组入院时GCS评分、APACHE Ⅱ评分和TNF-?、IL-1β、IL-6、IL-10浓度比较差异无统计学意义（P＞0.05）。治疗组3 d后炎症介质浓度即较对照组明显降低，比较差异有统计学意义（P＜0.05）。治疗组GCS评分明显改善，呼吸机使用时间和ICU住院时间明显缩短，与对照组相比差异有统计学意义（P 均＜0.05），28 d 死亡率有所降低，但差异无统计学意义（P＞0.05）。结论 早期使用FDP可以通过对神经细胞能量代谢的改善，稳定细胞内环境和膜功能，降低炎症介质浓度，以缩短呼吸机使用时间和ICU住院时间。? 　　【关键词】 重度颅脑创伤； 1,6-二磷酸果糖； 炎症介质； 预后? 　　The effect of 1,6-diphosphate fructose(1,6-FDP) on the concentration of inflammatory mediators and the prognosis of cranium-brain injury WANG Jing-en,CAI Jin-fang,WANG Zhi-hua,SHENG Ying,ZHU Nian,QU Wei.Nanhui Branch of Huashan Hospital Affiliated to Fudan University, Shanghai 201300,China? 　　【Abstract】 Objective This study was designed to observe the effect of 1,6 - diphosphate fructose(1,6 - FDP) on the concentration of inflammatory mediators and the Prognosis of cranium-brain injury.Methods 100 patients were admitted to ICU(Intensive Care Unit) in Nanhui Central Hospital from april 2008 to June 2010 and randomizely separated into 2 groups. They were both treated with such conventional medicines. The treatment group were given 1,6 - diphosphate (FDP) 10 g/d(id) on the admission day and the control group were treated with the same conventional medicine. The cerebrospinal fluid and serum concentration of TNF-?, IL-1β, IL-6, IL-10 on 1th day, 3th day, 5th day, and 7th day were analysed and compared. In the experiment,The score of Glasgow Coma Scale(GCS),APACHEⅡ, ICU admission, aeration time and mortality of the two groups were investigated in the before and after treatment.Results There was no significant difference between the two groups in the Glasgow Coma Scale, APACHEⅡ, TNF-α, IL-6 and IL-10 in the first day (P0.05). When compared wi