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Clinical study on the therapeutic effects and mechanism of progesterone in the treatment for acute severe head injury
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF SURGERY
- Issue:
- 2
- DOI:
- 10.3760/j.issn.0529-5815.2007.02.011
- Key Word:
- 孕酮;颅脑损伤;临床试验;15-F2t-isoprostane;TNF-α
Abstract： 目的 探讨孕酮治疗急性重型颅脑损伤病人的作用机制和疗效.方法 56例急性重型颅脑损伤病人随机分成常规治疗组(n=30)和孕酮治疗组(n=26),比较两组患者急性治疗期格拉斯哥昏迷评分(GCS)和格拉斯哥预后评分(GOS)、神经功能恢复和生活质量状况(KPS).患者入院当时、第5天和第10天,分别抽取静脉血,采用放射免疫分析法测定血清孕酮和TNF-α,酶标放射免疫法测定15-F2t-isoprostane(15-F2t-Ips).结果 两组患者死亡率、急性治疗期GCS评分、治疗第10天GOS评分和语言及运动障碍程度分级评估,均无显著差异(P＞0.05);治疗后3个月随访,孕酮治疗组患者GOS评分、语言障碍程度分级评估和远期生活质量评估,均明显优于常规治疗组(P＜0.05);两组患者运动功能障碍程度分级评估无显著差异(P＞0.05).入院第5天,常规治疗组患者血清15-F2t-Ips和TNF-α均有增高,第10天下降.与常规治疗组比较,孕酮治疗组患者入院第5、10天血清孕酮显著增高(P＜0.05);血清TNF-α和15-F2t-Ips显著减低(P＜0.05).结论 应用孕酮治疗急性重型颅脑损伤,可以促进病人神经功能康复,改善预后;孕酮对急性重型颅脑损伤病人的神经保护作用与其抑制脑损伤后脂质过氧化反应和炎症反应有关.
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