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目的:观察重型创伤性脑损伤(severe traumatic brain injury,sTBI)患者血浆IL-1β与S-100β蛋白含量变化,以及醒脑静注射液对IL-1β与S-100β蛋白含量的影响。方法:51例sTBI患者随机分成醒脑静治疗组(A组,n=26)和对照组(B组,n=25)。B组采用脱水、止血、必要时手术等治疗,A组在上述治疗的基础上给予醒脑静注射液治疗。两组均于伤后6h、24h、3d、7d、15d等各时间点采用酶联免疫吸附试验(ELISA)测定血浆IL-1β与S-100β蛋白含量,并与健康成年人作为正常对照组比较(C组,n=12);分析各时间点两组血浆IL-1β与S-100β蛋白含量与格拉斯哥昏迷评分(GCS)的相关性。结果:伤后各时间点A、B两组sTBI患者血浆IL-1β与S-100β蛋白含量明显高于C组(P?0.01),但两组间IL-1β与S-100β蛋白含量在伤后6h差异无统计学意义(P<0.05)。醒脑静注射液治疗后各时间点A组血浆IL-1β与S-100β蛋白含量低于B组(P?0.05)。A、B组于伤后各时间点血浆IL-1β与S-100β蛋白含量均与GCS评分呈负相关;与B组比较,出院时A组预后较好。结论:醒脑静能够降低sTBI患者血浆IL-1β与S-100β含量,改善预后,具有脑保护作用,其脑保护机制可能与醒脑静能减轻血浆IL-1β和S-100β蛋白介导的损伤性脑细胞炎症反应有关。
Objective: To observe the changes of plasma IL-1β and S-100β in patients with severe traumatic brain injury (sTBI) and the effects of xingnaojing injection on the content of IL-1β and S-100β. Methods: Fifty-one patients with sTBI were randomly divided into Xingnaojing group (n = 26 in group A) and control group (n = 25 in group B). Group B was treated with dehydration, hemostasis and operation if necessary. Group A was given Xingnaojing injection on the basis of the above treatment. The levels of IL-1β and S-100β in plasma were detected by enzyme linked immunosorbent assay (ELISA) at 6h, 24h, 3d, 7d, 15d after injury and compared with healthy adults (Group C, n = 12). The correlation between plasma IL-1β and S-100β protein levels and Glasgow coma score (GCS) at each time point was analyzed. Results: The levels of plasma IL-1β and S-100β protein in sTBI patients at each time point after injury were significantly higher than those in group C (P <0.01), but the levels of IL-1β and S-100β 6h after the difference was not statistically significant (P <0.05). The levels of IL-1β and S-100β in plasma of A group at each time point after Xingnaojing injection were lower than those in B group (P <0.05). The plasma levels of IL-1β and S-100β in group A and group B were negatively correlated with GCS score at each time point after injury. Compared with group B, group A had a better prognosis at discharge. Conclusion: Xingnaojing can decrease the plasma levels of IL-1β and S-100β, improve the prognosis of patients with sTBI, and have a protective effect on the brain. The protective mechanism of Xingnaojing may be related to Xingnaojing’s decreasing of plasma IL-1β and S-100β protein Damaged brain cell inflammatory response.