Department of Emergency Medicine, Emory University School of Medicine, 1365 B Clifton Road NE, Suite 5100, Atlanta, GA 30322, USA.
PM R. 2011 Jun;3(6 Suppl 1):S100-10. doi: 10.1016/j.pmrj.2011.03.010.
There is growing recognition that traumatic brain injury is a highly variable and complex systemic disorder that is refractory to therapies that target individual mechanisms. It is even more complex in elderly persons, in whom frailty, previous comorbidities, altered metabolism, and a long history of medication use are likely to complicate the secondary effects of brain trauma. Progesterone, one of the few neuroprotective agents that has shown promise for the treatment of acute brain injury, is now in national and international phase 3 multicenter trials. New findings show that vitamin D hormone (VDH) and VDH deficiency in the aging process (and across the developmental spectrum) may interact with progesterone and treatment for traumatic brain injury. In this article we review the use of progesterone and VDH as biologics-based therapies along with recent studies demonstrating that the combination of progesterone and VDH may promote better functional outcomes than either treatment independently.
越来越多的人认识到，创伤性脑损伤是一种高度可变且复杂的系统性疾病，针对单一机制的治疗方法对此往往收效甚微。对于老年人来说，情况更为复杂，他们往往身体虚弱，合并多种疾病，代谢改变，长期用药，这些都可能使脑外伤的继发性影响更加复杂。孕激素是少数几种有希望用于治疗急性脑损伤的神经保护剂之一，目前正在进行国家和国际 3 期多中心试验。新的研究结果表明，维生素 D 激素（VDH）和衰老过程中（以及整个发育过程中）的 VDH 缺乏可能与孕激素相互作用，并影响创伤性脑损伤的治疗。本文综述了孕激素和 VDH 作为基于生物制剂的治疗方法的应用，以及最近的研究表明，孕激素和 VDH 的联合应用可能比单独使用任何一种治疗方法都能带来更好的功能结果。
