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脑活素可促进轻度创伤性脑损伤患者的认知恢复:双盲、安慰剂对照、随机研究。

Cerebrolysin enhances cognitive recovery of mild traumatic brain injury patients: double-blind, placebo-controlled, randomized study.

作者信息

Chen Chun-Chung, Wei Sung-Tai, Tsaia Shiu-Chiu, Chen Xian-Xiu, Cho Der-Yang

机构信息

Department of Neurosurgery, China Medical University Hospital , Taichung , Taiwan.

出版信息

Br J Neurosurg. 2013 Dec;27(6):803-7. doi: 10.3109/02688697.2013.793287. Epub 2013 May 8.

Abstract

In adults, mild traumatic brain injury (MTBI) frequently results in impairments of cognitive functions which would lead to psychological consequences in the future. Cerebrolysin is a nootropic drug, and can significantly improve cognitive function in patients with Alzheimer's disease and stroke. The purpose of this study was to investigate how Cerebrolysin therapy enhances cognitive recovery for mild traumatic brain injury patients using a double-blinded, placebo-controlled, randomized phase II pilot study. Patients having head injury within 24 h sent to our hospital were screened and recruited if patients were alert and conscious, and had intracranial contusion haemorrhage. From July 2009 to June 2010, totally, thirty-two patients were recruited in the double-blinded, placebo-controlled, and randomized study. Patients were randomized to receive Cerebrolysin (Group A, once daily intravenous infusion of 30 mL Cerebrolysin over a 60-min period for 5 days) or placebo (Group B, same dosage and administration of normal saline as Group A). The primary outcome measures were differences of cognitive function including Mini-Mental Status Examination (MMSE), and Cognitive Abilities Screening Instrument (CASI) scores between baseline and week 1, between baseline and week 4, and between baseline and week 12. Thirty-two patients completed the trial. For Group A, the CASI score difference between baseline and week 12 was 21.0 ± 20.4, a significantly greater change than that of Group B (7.6 ± 12.1) (p = 0.0461). Besides, drawing function (one of the domains of CASI; p = 0.0066) on week 4 and both drawing function (p = 0.0472) and long-term memory (one of the domains of CASI; p = 0.0256) on week 12 were also found to be significantly improved in the patients receiving Cerebrolysin treatment. Our results suggest that Cerebrolysin improves the cognitive function of the MTBI in patients at 3rd month after injury, especially for long-term memory and drawing function.

摘要

在成年人中,轻度创伤性脑损伤(MTBI)常常导致认知功能受损,这可能会在未来引发心理问题。脑蛋白水解物是一种益智药,能够显著改善阿尔茨海默病和中风患者的认知功能。本研究的目的是通过一项双盲、安慰剂对照、随机的II期试验性研究,探讨脑蛋白水解物疗法如何促进轻度创伤性脑损伤患者的认知恢复。对伤后24小时内送至我院的头部受伤患者进行筛选,若患者意识清醒且无颅内挫伤出血,则予以招募。从2009年7月至2010年6月,共有32例患者被纳入这项双盲、安慰剂对照的随机研究。患者被随机分为接受脑蛋白水解物治疗组(A组,每天静脉输注一次30 mL脑蛋白水解物,60分钟输完,共5天)或安慰剂组(B组,剂量和给药方式与A组相同,但使用生理盐水)。主要观察指标为认知功能差异,包括基线与第1周、基线与第4周以及基线与第12周之间的简易精神状态检查表(MMSE)和认知能力筛查量表(CASI)得分。32例患者完成了试验。A组在基线与第12周之间的CASI得分差异为21.0±20.4,变化显著大于B组(7.6±12.1)(p = 0.0461)。此外,在接受脑蛋白水解物治疗的患者中,第4周的绘图功能(CASI的一项指标;p = 0.0066)以及第12周的绘图功能(p = 0.0472)和长期记忆(CASI的一项指标;p = 0.0256)也均有显著改善。我们的研究结果表明,脑蛋白水解物可改善创伤性脑损伤患者伤后3个月时的认知功能,尤其是长期记忆和绘图功能。

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