大剂量维生素C和E对颅脑外伤急性期脑保护作用
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- 英文论文题名：Protective effect of high dose vitamin C and E on brain injury in acute brain injury
- 论文作者：李宝东 ; 陈冬云 ; 谢建勤 ; 殷桥 ; 陶玉峰 ; 杨来华 ; 吴旻 ; 陈泽军
- 英文论文作者：Li Bao-dong ; Chen Dong-yun ; Xie Jian-qin ; Yin Qiao ; Tao Yu-feng ; Yang Lai-hua ; Wu Hao ; Chen Ze-jun ; Danyang City Hospital of Traditional Chinese Medicine ; Affiliated Hospital of Jiangsu University
- 年：2016
- 作者机构：丹阳市中医医院;江苏大学附属医院;
- 论文关键词：维生素C ; 维生素E ; 丙二醛(MDA) ; 超氧化物歧化酶(SOD) ; 颅脑外伤
- 英文论文关键词：vitamin C ; vitamin E ; malondialdehyde(MDA) ; superoxide dismutase(SOD) ; brain injury
- 会议召开时间：2016-12-01
- 会议录名称：中国医师进修论文选编
- 语种：中文
- 分类号：R651.15
- 学会代码：BCLK
- 会议名称：2016年12月中国医师进修学术交流会
- 会议地点：中国北京
- 主办单位：中国医师进修编委会
- 学会名称：百川利康（北京）国际医学研究院
- 页数：4
- 文件大小：635k
- 原文格式：D
- 会议级别：全国
摘要
目的通过观察大剂量维生素C和E对急性颅脑外伤患者血清超氧化物歧化酶(SOD)和丙二醛(MDA)含量的影响,从脂质氧化反应角度探讨大剂量维生素C和E对急性颅脑外伤脑保护机制。方法将120例急性颅脑损伤患者随机分为依达拉奉组(43例)、维生素C和E组(37例)和常规组(40例)。分别测定患者入院时、第3d、第7d及第14d血清中MDA、SOD的含量,并行出院时、3个月后行格拉斯哥预后分级(GOS)。结果三组患者MDA伤后即出现明显增高,治疗3天后MDA开始降低,依达拉奉组、维生素C和E组较常规组下降幅度明显,有统计学意义(P值均<0.00001),依达拉奉组、维生素C和E组两组之间第3、7、14天MDA比较差异无统计学意义(P值=0.07635,0.28697,0.18119);三组患者SOD伤后先出现反应性升高,治疗3天后开始下降,依达拉奉组、维生素C和E组下降幅度与常规组比较有明显差异,有统计学意义(P值均<0.00001),依达拉奉组、维生素C和E组两组之间第3、7、14天SOD比较差异无统计学意义(P值=0.30415,0.34253,0.18831>0.05);近期预后出院时GOS评分依达拉奉组、维生素C和E组明显高于常规组,差异存在统计学意义(P值均<0.0001),依达拉奉组、维生素C和E组两组之间比较差异无统计学意义(P值=0.39143);远期预后3个月GOS评分依达拉奉组、维生素C和E组明显高于常规组,差异存在统计学意义(P值=0.00323,0.00395),依达拉奉组、维生素C和E组两组之间比较差异无统计学意义(P值=0.43797)。结论大剂量维生素C联合维生素E可减轻脂类过氧化反应,减少脂质过氧化物的产生,保护超氧化物歧化酶等含基酶的活性,清除氧自由基,保护神经细胞。采用大剂量维生素C和E治疗急性颅脑外伤不失为一种安全、廉价、有效的好方法。
Objective By observing the effect of large dose of vitamin C and E on serum superoxide dismutase(SOD) and malondialdehyde(MDA) content in patients with acute craniocerebral injury, the protective mechanism of large dose of vitamin C and E on acute brain injury was discussed from the perspective of lipid oxidation.Method 120 cases of patients with acute craniocerebral injury were randomly divided into edaravone group(43 cases), vitamin C and E group(37 cases) and control group(40 cases). The contents of, MDA, 3D, SOD, and in patients with, 14 d and 7d were measured, and the prognosis of the patients was months after discharge, and the prognosis of the patients was 3 months(GOS).Result Three groups of MDA patients after injury is significantly increased, 3 days after treatment with MDA began to decrease, the edaravone group, vitamin C and E group compared with the conventional group decreased significantly, statistical significance(P < 0.00001) and edaravone group, vitamin C and E group between the two groups in the 3, 7, 14 days MDA compared no statistical significance(P value =0.07635,0.28697, 0.18119); Three groups of SOD in patients with injury first appeared increased in response, 3 days after treatment began to decline, edaravone group, vitamin C and E group decreased significantly and the conventional group compared with significant difference, was statistically significant(P < 0.00001) and edaravone group, vitamin C and E group between the two groups in the 3, 7, 14 days SOD difference no statistical significance(P value =0.30415,0.34253, 0.18831 > 0.05);Recent prognosis of discharge gos edaravone group, vitamin C and E group is obviously higher than that of normal group, and the differences were significant(P < 0.0001) and edaravone group, vitamin C and E group between the two groups the difference no statistical significance(P value =0.39143); long-term prognosis of 3 months gos edaravone group, vitamin C and E group was significantly higher than that of the conventional group, the difference is statistical significance(P value =0.00323,0.00395) and edaravone group, vitamin C and E group between the two groups the difference no statistical significance(P value =0.43797).Conclusion Large doses of vitamin C and vitamin E can reduce lipid peroxidation, reduce the production of lipid peroxides, protection of superoxide dismutase(SOD), containing basal enzyme activity, scavenging oxygen free radical, protect nerve cells.It is a safe, cheap and effective method to treat acute traumatic brain injury by high dose vitamin C and E.
Objective By observing the effect of large dose of vitamin C and E on serum superoxide dismutase(SOD) and malondialdehyde(MDA) content in patients with acute craniocerebral injury, the protective mechanism of large dose of vitamin C and E on acute brain injury was discussed from the perspective of lipid oxidation.Method 120 cases of patients with acute craniocerebral injury were randomly divided into edaravone group(43 cases), vitamin C and E group(37 cases) and control group(40 cases). The contents of, MDA, 3D, SOD, and in patients with, 14 d and 7d were measured, and the prognosis of the patients was months after discharge, and the prognosis of the patients was 3 months(GOS).Result Three groups of MDA patients after injury is significantly increased, 3 days after treatment with MDA began to decrease, the edaravone group, vitamin C and E group compared with the conventional group decreased significantly, statistical significance(P < 0.00001) and edaravone group, vitamin C and E group between the two groups in the 3, 7, 14 days MDA compared no statistical significance(P value =0.07635,0.28697, 0.18119); Three groups of SOD in patients with injury first appeared increased in response, 3 days after treatment began to decline, edaravone group, vitamin C and E group decreased significantly and the conventional group compared with significant difference, was statistically significant(P < 0.00001) and edaravone group, vitamin C and E group between the two groups in the 3, 7, 14 days SOD difference no statistical significance(P value =0.30415,0.34253, 0.18831 > 0.05);Recent prognosis of discharge gos edaravone group, vitamin C and E group is obviously higher than that of normal group, and the differences were significant(P < 0.0001) and edaravone group, vitamin C and E group between the two groups the difference no statistical significance(P value =0.39143); long-term prognosis of 3 months gos edaravone group, vitamin C and E group was significantly higher than that of the conventional group, the difference is statistical significance(P value =0.00323,0.00395) and edaravone group, vitamin C and E group between the two groups the difference no statistical significance(P value =0.43797).Conclusion Large doses of vitamin C and vitamin E can reduce lipid peroxidation, reduce the production of lipid peroxides, protection of superoxide dismutase(SOD), containing basal enzyme activity, scavenging oxygen free radical, protect nerve cells.It is a safe, cheap and effective method to treat acute traumatic brain injury by high dose vitamin C and E.
引文
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[12]黄进,杨国宇,李宏基,等.抗氧化剂作用机制研究进展[J].自然杂志,2003,26(2):76.
[13]D'Uscio LV,Milstien S,Richardson D,et al.Longterm vitamin C treatment increases vascular tetrahydrobiopterin1evels and nitric oxide synthase activity[J].Circ Res,2003,92(1):88-95.
[14]Suhail M,Faizul Suhail M,Khan H.Role of vitamins Cand e in regulating antioxidant and pro-oxidant markers in preeclampsia[J].J Clin Biochem Nutr,2008,43(3):210-220.
[15]朱长林,张文彬,孙鹏等.维生素E与维生素C的联合免疫调节及抗氧化作用[J].中国临床康复,2006,10(36):120-122
[16]Ziegler EE,F iler LJ.现代营养学.闻芝梅,陈君石主译.第7版.北京:人民卫生出版社,1998,4
[17]Milton Prabu S,Shagirtha K,Renugadevi J.Quercetin in combination with vitamins(C and E)improves oxidative stress and renal injury in cadmium intoxicated rats[J].Eur Rev Med Pharmacol Sci,2010,14(11):903-914.
[18]Rutkowski M,Matuszewski T.Kedziora J.et al.Vitamins E,A and C as antioxidatives[J].Pol Merkur Lekarski.2010,29(174):377-381
[2]Slotlcin A,Seidler FJ.Oxidative stress from diverse developmental neurotoxicants antioxidants protect against lipid peroxidation withant preventing cell loss[J].Neurotoxicol Teretol,2010,32(2):124-131。
[3]Kleinkauf-Rocha J,Bobermin LD,Machado PD,et al.Lipoic acid increases glutamate uptake,glutamine synthetase activity and glutathione content in C6 astrocyte cell line[J].Int J Dev Neurosci,2012,31(3):165-170。
[4]Pluta R M,Hansen-Schwartz J,Dreier J,et al.Cerebral vasospasm following subarachnoid hemorrhage:time fora new world of thought[J].Neurol Res,2009,31(2):151。
[5]潘新发.脑出血后血肿周围组织炎症反应的研究进展[J].国际神经病学神经外科学杂志,2010,37(3):263.
[6]Allen CL,Bayraktutan U.Oxidative stress and its role in the pathogenesis of ischaemic stroke[J].Int J Stroke,2009,4(6):461-470.
[7]Ozkul A,Akyol A,Yenisey C,et al.Oxidative stress in acute ischemic stroke[J].J Clin Neurosci,2007,14(11):1062-1066.
[8]阮世宏,郑秀珏,潘向东,等.血清炎性因子浓度对急性脑出血恶化的预测价值[J].浙江临床医学,2013,15(11):1636-1638.
[9]Suhail M,Faizul Suhail M,Khan H.Role of vitamins C and e in regulating antioxidant and pro-oxidant markers in preeclampsia[J]。J Clin Biochem Nutr,2008,43(3):210-220.
[10]翟建华,陈素仙,苏一星,等.维生素E对大鼠心肌缺血再灌注损伤的影响[J]。中国现代医药杂志,2008,10(3):22-25
[11]Asemi Z,Taghizadeh M,Sarahroodi S,et a1.Assessment of the relationship of vitamin D with serum antioxidant vitamins E and A and their deficiencies in Iranian pregnant women[J].Saudi Med J,2010,31(10);1119-1123
[12]黄进,杨国宇,李宏基,等.抗氧化剂作用机制研究进展[J].自然杂志,2003,26(2):76.
[13]D'Uscio LV,Milstien S,Richardson D,et al.Longterm vitamin C treatment increases vascular tetrahydrobiopterin1evels and nitric oxide synthase activity[J].Circ Res,2003,92(1):88-95.
[14]Suhail M,Faizul Suhail M,Khan H.Role of vitamins Cand e in regulating antioxidant and pro-oxidant markers in preeclampsia[J].J Clin Biochem Nutr,2008,43(3):210-220.
[15]朱长林,张文彬,孙鹏等.维生素E与维生素C的联合免疫调节及抗氧化作用[J].中国临床康复,2006,10(36):120-122
[16]Ziegler EE,F iler LJ.现代营养学.闻芝梅,陈君石主译.第7版.北京:人民卫生出版社,1998,4
[17]Milton Prabu S,Shagirtha K,Renugadevi J.Quercetin in combination with vitamins(C and E)improves oxidative stress and renal injury in cadmium intoxicated rats[J].Eur Rev Med Pharmacol Sci,2010,14(11):903-914.
[18]Rutkowski M,Matuszewski T.Kedziora J.et al.Vitamins E,A and C as antioxidatives[J].Pol Merkur Lekarski.2010,29(174):377-381
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