摘要
目的观察血必净注射液联合肠内营养制剂对中重度颅脑损伤合并心肌损伤患者血清炎性因子、氨基末端B型钠尿肽原(NT-proBNP)、缺血修饰白蛋白(IMA)及心型脂肪酸结合蛋白(H-FABP)的影响。方法将53例中重度颅脑损伤合并心肌损伤患者随机分为对照组26例和观察组27例,对照组予以西医常规对症治疗,观察组在对照组治疗基础上予以血必净联合肠内营养制剂治疗,2组均以2周为1个疗程。治疗1个疗程后,观察2组血清肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)以及NT-proBNP、IMA及H-FABP水平变化情况,统计2组脑血肿治疗效果及不良反应发生情况。结果治疗后2组TNF-α、CRP、IL-6、NTproBNP、IMA以及H-FABP水平均显著降低(P均<0.05),且观察组上述指标水平均显著低于对照组(P<0.05);治疗后2组IL-10水平均显著升高(P均<0.05),且观察组IL-10水平显著高于对照组(P<0.05)。治疗1个疗程后,治疗组脑血肿治疗效果明显优于对照组(P<0.05),2组治疗期间均未发生明显不良反应。结论在西医对症治疗的基础上使用血必净注射液联合肠内营养制剂可增强治疗中重度颅脑损伤合并心肌损伤患者效果,可有效减轻炎症反应,对心肌功能具有保护作用,值得临床推广应用。
Objective It is to observe the effect of Xuebijing injection combined with enteral nutrition on serum inflammatory cytokines, NT-proBNP, ischemia modified albumin （IMA）, heart-type fatty acid-binding protein （H-FABP） in patients with moderate or severe craniocerebral injury complicated with myocardial injury. Methods Fifty-three patients with moderate or severe craniocerebral injury combined with myocardial injury were randomly divided into control group （26 cases） and observation group （27 cases）. The control group was treated with routine western symptomatic treatment. The observation group was given Xuebijing combined with enteral nutrition on the basis of the control group. Both groups were treated for 2 weeks. The changes of serum TNF-α, CRP, IL-6, IL-10 and NT-proBNP, IMA and H-FABP before and after treatment were observed in the two groups. The therapeutic effects were evaluated and the occurrence of adverse reactions was observed in both groups. Results After treatment, the levels of TNF-α, CRP, IL-6, NT-proBNP, IMA and H-FABP were significantly decreased（ P 〈0.05）, and that of IL-10 were significantly increased in both groups（ P 〈0.05）, and the decrease or increase in the observation group was more significant than that in the control group （ P 〈0.05）. The therapeutic effect of cerebral hematoma in the treatment group was significantly better than that in the control group （ P 〈0.05）. No obvious adverse reactions occurred during the treatment in the two groups. Conclusion The treatment with Xuebijing injection combined with enteral nutrition based on symptomatic treatment of western medicine can enhance the effect of treatment of patients with moderate or severe craniocerebral injury combined with myocardial injury. It can effectively reduce the inflammatory response, protect myocardial function, and is worthy of clinical application.
作者
甄根深
刘威
张奇峰
刘远
ZHEN Genshen;LIU Wei;ZHANG Qifeng;LIU Yuan(Beijing Luhe Hospital Affiliated to Capital Medical University,Beijing 101149)
出处
《现代中西医结合杂志》
CAS
2018年第20期2199-2202,共4页
Modern Journal of Integrated Traditional Chinese and Western Medicine
关键词
中重度颅脑损伤
心肌损伤
血必净注射液
肠内营养制剂
moderate to severe brain injury
myocardial injury
Xuebijing injection
enteral nutrition
作者简介
甄根深，男，副主任医师，研究方向为急诊重症监护。
