本文選題：血清IGF-1 + 奧拉西坦　； 參考：《新鄉(xiāng)醫(yī)學(xué)院》2017年碩士論文

【摘要】：背景如今,我國(guó)創(chuàng)傷性顱腦損傷(traumatic brain injury,TBI)的發(fā)病率居高不下,許多顱腦損傷患者意識(shí)恢復(fù)后遺留了不同程度地認(rèn)知功能障礙,研究顯示重度顱腦損傷患者重返社會(huì)可能性小,而輕度顱腦損傷患者伴隨認(rèn)知功能障礙的幾率較低,故本研究主要針對(duì)中度顱腦損傷患者。而近年來(lái)益智類藥物逐漸被用到該疾病中,其代表藥物奧拉西坦是一種新合成的γ-氨基丁酸(γ-aminobutyric acid,GABA)的衍生物,它主要作用在大腦的皮層、海馬等部位,不但能促進(jìn)學(xué)習(xí)記憶能力,還可以保護(hù)、激活及促進(jìn)神經(jīng)細(xì)胞功能恢復(fù)的一種中樞性神經(jīng)系統(tǒng)藥物。目的探討奧拉西坦作為一種益智藥,對(duì)中度顱腦損傷患者認(rèn)知障礙的療效,為中度創(chuàng)傷性顱腦損傷患者傷后認(rèn)知功能障礙的臨床治療提供一些理論根據(jù)與新思路,為認(rèn)知障礙干預(yù)治療提供有效的依據(jù)。方法選取我院于2015年9月到2016年8月收治的顱腦損傷患者120例。入院當(dāng)天行格拉斯哥昏迷指數(shù)(Glasgow coma scale,GCS)評(píng)分選出中度顱腦損傷患者,并于第2天對(duì)其選出患者應(yīng)用簡(jiǎn)易精神狀態(tài)檢查表(Mini-mental state examination,MMSE)進(jìn)行認(rèn)知功能的評(píng)定,根據(jù)GCS評(píng)分及MMSE結(jié)果選出中度顱腦損傷并伴認(rèn)知障礙患者48例,并將其隨機(jī)分為奧拉西坦治療組和常規(guī)治療組,對(duì)兩組治療結(jié)果對(duì)比,并應(yīng)用統(tǒng)計(jì)學(xué)進(jìn)行分析。同時(shí)對(duì)2組血清IGF-1濃度水平采用ELISA法進(jìn)行測(cè)定。進(jìn)而對(duì)其所得結(jié)果應(yīng)用統(tǒng)計(jì)學(xué)分析。結(jié)果1.治療前兩組GCS評(píng)分比較差異無(wú)統(tǒng)計(jì)學(xué)意義,治療后兩組GCS評(píng)分較治療前均有所改善,差異有統(tǒng)計(jì)學(xué)意義;治療7天后,兩組之間的GCS評(píng)分差異無(wú)統(tǒng)計(jì)學(xué)意義,14天后,治療組GCS評(píng)分明顯高于常規(guī)組,差異有統(tǒng)計(jì)學(xué)意義;2.臨床治療7天與治療2天比較時(shí),兩組患者的MMSE評(píng)分及血清IGF-1濃度水平有所提高,其差異有統(tǒng)計(jì)學(xué)意義,臨床治療14天與治療7天后比較時(shí),兩組患者的MMSE評(píng)分及血清IGF-1濃度水平提高明顯,其差異同樣具有統(tǒng)計(jì)學(xué)意義;治療2天、7天后,兩組之間的MMSE評(píng)分及血清IGF-1濃度水平差異無(wú)統(tǒng)計(jì)學(xué)意義,治療14天后兩組相比時(shí),治療組的MMSE評(píng)分及血清IGF-1濃度水平較常規(guī)組明顯提高,差異有統(tǒng)計(jì)學(xué)意義;結(jié)論1.奧拉西坦治療與常規(guī)治療對(duì)改善顱腦損傷患者認(rèn)知障礙均有效,但前者療效優(yōu)于后者。2.血清IGF-1可作為早期篩查顱腦損傷后認(rèn)知功能障礙的客觀指標(biāo),并為臨床干預(yù)提供有效的信息。
[Abstract]:Background nowadays, the incidence of traumatic brain injury (TBI) is high in China. Many patients with craniocerebral injury have left behind different degrees of cognitive dysfunction after their consciousness recovery. Research shows that patients with severe craniocerebral injury are less likely to reintegrate into society. Patients with mild craniocerebral injury were less likely to be associated with cognitive impairment, so this study was mainly focused on moderate craniocerebral injury patients. In recent years, probiotics have been gradually used in the disease. The representative drug oxetam is a new synthetic derivative of 緯 -aminobutyric acid, which plays a major role in the cortex, hippocampus and other parts of the brain, and can not only promote learning and memory, but also improve the ability of learning and memory. A central nervous system drug that protects, activates, and promotes the functional recovery of nerve cells. Objective to explore the effect of olaxetam on cognitive impairment in patients with moderate craniocerebral injury, and to provide some theoretical basis and new ideas for the clinical treatment of cognitive dysfunction in patients with moderate traumatic craniocerebral injury. To provide an effective basis for the intervention treatment of cognitive impairment. Methods 120 patients with craniocerebral injury admitted in our hospital from September 2015 to August 2016 were selected. On the day of admission, Glasgow coma scale was used to select patients with moderate craniocerebral injury, and the cognitive function of the selected patients was evaluated by mini-mental state examination on the second day. According to the results of GCS and MMSE, 48 patients with moderate craniocerebral injury with cognitive impairment were randomly divided into two groups: oxiracetam treatment group and routine treatment group. The results of the two groups were compared and statistically analyzed. At the same time, the level of serum IGF-1 was measured by ELISA method. Then statistical analysis was applied to the results obtained. Result 1. There was no significant difference in GCS scores between the two groups before treatment, but there was no significant difference in GCS scores between the two groups after treatment, and there was no significant difference in GCS scores between the two groups after 7 days of treatment. The GCS score of the treatment group was significantly higher than that of the routine group, and the difference was statistically significant. The MMSE score and serum IGF-1 level of the two groups were significantly higher than that of the two groups on the 7th day and the 2nd day after the treatment, and the difference was statistically significant between 14 days and 7 days after treatment. The MMSE score and serum IGF-1 level of the two groups were significantly increased, and the difference was also statistically significant, but there was no significant difference in MMSE score and serum IGF-1 level between the two groups after 2 days and 7 days of treatment. After 14 days of treatment, the MMSE score and serum IGF-1 level in the treatment group were significantly higher than those in the conventional group, and the difference was statistically significant. Conclusion 1. Both olaxetam and routine therapy were effective in improving cognitive impairment in patients with craniocerebral injury, but the former was better than the latter. Serum IGF-1 can be used as an objective index for early screening of cognitive dysfunction after craniocerebral injury and provide effective information for clinical intervention.
【學(xué)位授予單位】：新鄉(xiāng)醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R651.15

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本文編號(hào)：1850829