奥拉西坦注射液治疗老年颅脑损伤患者的临床效果及对炎症和氧化应激的影响

Efficacy of oxiracetam in treatment of craniocerebral brain injury in elderly patients and its effects on inflammatory and oxidative stress

摘要:

目的 观察奥拉西坦注射液对老年颅脑损伤患者的疗效以及对炎症和氧化应激的影响。方法 80例老年颅脑损伤患者随机分为对照组和观察组(各40例)。对照组根据病情进行常规治疗,观察组患者在常规治疗基础上给予奥拉西坦注射液治疗,1次/d,治疗周期为12d。采用ELISA法检测患者治疗前后血清氧化应激指标[包括丙二醛(MDA)、过氧化脂质(LPO)、超氧化物歧化酶(SOD)、总抗氧化能力(TAOC)等]及炎症因子[包括白细胞介素-4(IL-4)、IL-10、IL-1β、肿瘤坏死因子－α(TNF-α)]的变化。同时对2组患者的清醒时间及意识恢复率等疗效指标进行比较。数据采用GraphPad Prism 5.0软件进行分析。2组间比较采用t/χ²检验,生存分析采用Kaplan-Meier法,并行Log-rank检验。结果 与治疗前相比,2组老年性颅脑损伤患者IL-4、IL-10、TAOC、SOD均明显上升,TNF-ɑ、IL-1β、MDA、LPO明显降低(P<0.05)。观察组与对照组相比,治疗后,观察组SOD和IL-10显著高于对照组(P<0.05),MDA显著低于对照组(P<0.05)。在治疗期间观察组患者意识恢复率明显高于对照组[85.0%(34/40)和67.5%(27/40), P<0.05],清醒时间也明显长于对照组[(7.56±1.52)和(5.21±1.49)d, P<0.05]。生存分析表明,观察组患者的生存率高于对照组,差异有统计学意义[92.5%(37/40)和65.5%(26/40),P<0.05]。结论 奥拉西坦对老年性颅脑损伤患者有一定治疗作用,其机制可能与抑制炎症反应和调节氧化应激反应有关。

Abstract:

Objective To investigate the clinical effects of oxiracetam in the treatment of elderly patients with craniocerebral brain injury, and its effects on inflammation and oxidative stress. Methods A total of 80 elderly patients with cranio-cerebral brain injury were randomly divided into observation group and control group (40 in each group). Both groups received routine treatment based on the patient′s condition, while the observation group received additional oxiracetam once a day for 12 days. ELISA was employed to measure the expression levels of malondialdehyde (MDA), lipoeroxides(LPO), superoxide dismutase (SOD), and total antioxidant capacity (TAOC), and cytokines interleukin-4 (IL-4), IL-10, IL-1β, and tumor necrosis factor-α (TNF-α). Meanwhile, the two groups were compared for sober time during treatment and consciousness recovery time. Data were statistically analyzed using GraphPad Prism 5.0. The comparison between the two groups was performed by t/χ² test. Kaplan-Meier survival analysis and Log-rank test were also performed. Results Compared with before the treatment, IL-4, IL-10, TAOC and SOD increased significantly, and TNF-ɑ, IL-1β, MDA and LPO decreased significantly (P<0.05) in both groups. After the treatment, SOD and IL-10 in the observation group were significantly higher than those in the control group (P<0.05), and the MDA was significantly lower than the control group (P<0.05). During the treatment, the recovery rate of consciousness in the observation group was significantly higher than that in the control group [85.0%(34/40) vs 67.5%(27/40), P<0.05], and the awake time in the former was also significantly longer than that in the latter [(7.56±1.52) vs (5.21±1.49)d, P<0.05]. The survival analysis showed that the survival rates of the observation group was higher than that of the control group, and the difference was statistically significant[92.5%(37/40) vs 65.5%(26/40),P<0.05]. Conclusion Oxiracetam is effective for craniocerebral brain injury in the elderly patients, and its mechanism may be related to inhibition of inflammatory reaction and oxidative stress.