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促红细胞生成素对创伤性脑损伤患者序贯器官衰竭评估(SOFA)评分、格拉斯哥昏迷量表评分及死亡率的影响:一项随机双盲对照试验

Effect of erythropoietin on SOFA score, Glasgow Coma Scale and mortality in traumatic brain injury patients: a randomized-double-blind controlled trial.

作者信息

Boskabadi Seyyed Javad, Heydari Fatemeh, Mohammadnejad Farhad, Gholipour Baradari Afshin, Moosazadeh Mahmood, Dashti Ayat

机构信息

Departments of Clinical Pharmacy.

Department of Anesthesiology, School of Medicine, Sari Imam Khomeini Hospital.

出版信息

Ann Med Surg (Lond). 2024 May 15;86(7):3990-3997. doi: 10.1097/MS9.0000000000002143. eCollection 2024 Jul.

DOI:10.1097/MS9.0000000000002143
PMID:38989196
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11230820/
Abstract

BACKGROUND

Recent studies suggest that erythropoietin has an anti-inflammatory effect on the central nervous system. The authors aimed to investigate the effect of erythropoietin on Glasgow Coma Scale (GCS), Sequential Organ Failure Assessment (SOFA) scores, and the mortality rate of traumatic brain injury (TBI) patients.

METHODS

Sixty-eight patients with available inclusion criteria were randomly allocated to the control or intervention groups. In the intervention group, erythropoietin (4000 units) was administrated on days 1, 3, and 5. In the control group, normal saline on the same days was used. The primary outcomes were the GCS and SOFA score changes during the intervention. The secondary outcomes were the ventilation period during the first 2 weeks and the 3-month mortality rate.

RESULTS

Erythropoietin administration significantly affected SOFA score over time (=0.008), but no significant effect on the GCS, and duration of ventilation between the two groups was observed. Finally, erythropoietin had no significant effect on the three-month mortality (23.5% vs. 38.2% in the erythropoietin and control group, respectively). However, the mortality rate in the intervention group was lower than in the control group.

CONCLUSION

Our finding showed that erythropoietin administration in TBI may improve SOFA score. Therefore, erythropoietin may have beneficial effects on early morbidity and clinical improvement in TBI patients.

摘要

背景

近期研究表明,促红细胞生成素对中枢神经系统具有抗炎作用。作者旨在研究促红细胞生成素对创伤性脑损伤(TBI)患者格拉斯哥昏迷量表(GCS)评分、序贯器官衰竭评估(SOFA)评分及死亡率的影响。

方法

68例符合纳入标准的患者被随机分配至对照组或干预组。干预组在第1、3和5天给予促红细胞生成素(4000单位)。对照组在相同日期使用生理盐水。主要结局为干预期间GCS和SOFA评分的变化。次要结局为前2周的通气时间及3个月死亡率。

结果

随着时间推移,促红细胞生成素给药对SOFA评分有显著影响(P = 0.008),但对GCS无显著影响,且两组间通气时间无差异。最后,促红细胞生成素对3个月死亡率无显著影响(促红细胞生成素组和对照组分别为23.5%和38.2%)。然而,干预组的死亡率低于对照组。

结论

我们的研究结果表明,TBI患者使用促红细胞生成素可能改善SOFA评分。因此,促红细胞生成素可能对TBI患者的早期发病率和临床改善具有有益作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f894/11230820/444ea8d5914c/ms9-86-3990-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f894/11230820/69db8ce46ef8/ms9-86-3990-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f894/11230820/6b11f9b1371d/ms9-86-3990-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f894/11230820/444ea8d5914c/ms9-86-3990-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f894/11230820/69db8ce46ef8/ms9-86-3990-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f894/11230820/6b11f9b1371d/ms9-86-3990-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f894/11230820/444ea8d5914c/ms9-86-3990-g003.jpg

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本文引用的文献

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The effects of topical erythropoietin on non-surgical treatment of periodontitis: a preliminary study.局部应用促红细胞生成素对牙周炎非手术治疗的影响:一项初步研究。
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The Adaptive designs CONSORT Extension (ACE) statement: a checklist with explanation and elaboration guideline for reporting randomised trials that use an adaptive design.适应性设计 CONSORT 扩展(ACE)声明:一份带有解释和说明指南的清单,用于报告使用适应性设计的随机试验。
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Updates on Novel Erythropoiesis-Stimulating Agents: Clinical and Molecular Approach.新型促红细胞生成剂的进展:临床与分子方法
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