Shakeri Moslem, Boustani Mohammad Reza, Pak Neda, Panahi Farid, Salehpour Firouz, Lotfinia Iraj, Meshkini Ali, Daghighi Shadi, vahedi Payman, Khani Mehdi, Taghiloo Dariush
Department of Neurosurgery, Imam Reza Teaching Hospital, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Clin Neurol Neurosurg. 2013 Oct;115(10):2019-22. doi: 10.1016/j.clineuro.2013.06.013. Epub 2013 Jul 18.
Severe traumatic brain injury (TBI) has a major role in mortality rate among the other types of trauma. The aim of this clinical study was to assess the effect of progesterone on the improvement of neurologic outcome in patients with acute severe TBI.
A total of 76 patients who had arrived within 8h of injury with a Glasgow Coma Score≤8 were enrolled in the study. In a randomized style 38 received progesterone (1mg/kg per 12h for 5 days) and 38 did not.
There was a better recovery rate and GOS score for the patients who were given progesterone than for those in the control group in a 3-months follow-up period (50% vs. 21%); subgroup analysis showed a significant difference in the percentage of favorable outcome between the two groups with GCS of 5-8 (p=0.03).
The use of progesterone may significantly improve neurologic outcome of patients suffering severe TBI up to 3 months after injury, especially those with 5≤GCS≤8, providing a potential benefit to the treatment of acute severe TBI patients. Considering this drug had no significant side effects, so progesterone could be used in patients with severe TBI as a neuro-protective drug.
在其他类型创伤中，重度创伤性脑损伤（TBI）在死亡率方面起主要作用。本临床研究的目的是评估孕酮对急性重度TBI患者神经功能转归改善的影响。
共纳入76例受伤后8小时内入院且格拉斯哥昏迷评分≤8分的患者。采用随机方式，38例接受孕酮治疗（1mg/kg，每12小时一次，共5天），38例未接受。
在3个月的随访期内，接受孕酮治疗的患者恢复率和格拉斯哥预后评分（GOS）均优于对照组（50%对21%）；亚组分析显示，格拉斯哥昏迷量表（GCS）评分为5 - 8分的两组患者在良好预后百分比方面存在显著差异（p = 0.03）。
使用孕酮可能显著改善重度TBI患者伤后3个月内的神经功能转归，尤其是GCS为5 - 8分的患者，为急性重度TBI患者的治疗提供了潜在益处。鉴于该药物无明显副作用，因此孕酮可作为神经保护药物用于重度TBI患者。
