| 沈俊,李道龙,杨振时,等.早期应用益生菌对动脉瘤性蛛网膜下腔出血38 例神经功能和认知功能恢复的影响[J].安徽医药,2022,26(9):1888-1891. |
| 早期应用益生菌对动脉瘤性蛛网膜下腔出血38 例神经功能和认知功能恢复的影响 |
| Influence of early application of probiotics treatment on the recoveries of neurological and cognitive functions in 38 patients with aneurysmal subarachnoid hemorrhage |
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| DOI：10.3969/j.issn.1009-6469.2022.09.045 |
| 中文关键词: 蛛网膜下腔出血 动脉瘤 益生菌 神经功能 认知功能 炎症水平 |
| 英文关键词: Subarachnoid hemorrhage Aneurysm Probiotics Neurological functions Cognitive functions Inflammation |
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| 目的探讨早期应用益生菌对动脉瘤性蛛网膜下腔出血病人神经功能和认知功能恢复的影响。方法选取2018年6月至2019年12月六安市第二人民医院收治的动脉瘤性蛛网膜下腔出血病人76例，采用随机数字表法分为观察组38例与对照组38例。对照组给予常规综合治疗，包括腰穿或腰大池脑脊液引流、钙离子拮抗剂、脱水、神经营养等治疗；观察组在对照组常规治疗的基础上，给予双歧杆菌三联活菌胶囊，每次2粒，1天2次，每粒胶囊活菌不低于1.0×107 CFU。观察并比较两组治疗1周后并发症、外周血炎症水平，以及短期(出院时)和远期(出院半年)神经功能和认知功能水平。结果观察组消化道出血、肺部感染、尿路感染的发生率均明显低于对照组(P<0.05)；观察组血清白细胞介素(IL)-6、肿瘤坏死因子-α(TNF-α)、降钙素原水平均明显低于对照组(P<0.05)，两组C反应蛋白(CRP)差异无统计学意义(P>0.05)；对照组、观察组病人出院时改良Rankin评分［2.00(1.75，3.00)分比2.00(1.00，2.00)分］、神经功能缺损评分［3.00(1.75，14.50)分比2.00(1.00，3.00)分］以及MMSE评分［(20.15±5.28)分比(24.07±6.70)分］之间均差异有统计学意义(P<0.05)，早期应用益生菌能显著改善病人出院时的神经功能与认知功能；对照组、观察组病人在出院半年时神经功能缺损评分［3.00(1.75，5.25)分比2.00(1.75，2.00)分］以及MMSE评分［(21.90±5.66)分比(24.77±4.29)］之间均差异有统计学意义(P<0.05)，而改良Rankin评分间［2.00(1.00，3.00)分比1.00(0.00，2.00)分］差异无统计学意义(P>0.05)，早期应用益生菌对神经功能缺损以及认知功能改善的治疗效应在出院半年仍然明显。结论动脉瘤性蛛网膜下腔出血病人早期应用益生菌能降低病人外周血炎症水平，并促进病人短期和远期的神经功能和认知功能的恢复。 |
| 英文摘要: |
| Objective To investigate the effects of early application of probiotics for the neurological and cognitive function recoveries among the aneurysmal subarachnoid hemorrhage (aSAH) patients.Methods Seventy-six aSAH patients who were admitted to Lu'an Second People's Hospital during June 2018 to December 2019 were selected and randomly assigned into two groups: experiment group and control group, with 38 patients in each group. The patients in control group received comprehensive treatments, including lumbar puncture or lumbar cistern drainage, applications of calcium channel blocker, dehydrating agent and neurotrophic medicine,while the observation group received bifidobacterium-triple viable bacteria capsules on the basis of the conventional treatment of the control group, each time 2 capsules, 2 times a day, and the numbers of viable bacteria in each capsule were higher than 1.0×107 CFU.After the treatment for a week, the incidence of complications, circulation inflammatory levels, and short-term (at discharge) as well as long-term (at 6 month after discharge) neurological and cognitive function levels were observed and compared between the two groups.Results The incidences of gastrointestinal hemorrhage, pulmonary infection and urinary tract infection in the observation group were significantly lower than those in the control group (P<0.05). The levels of interleukin (IL)-6, tumor necrosis factor-α (TNF-α), and procalcitonin(PCT) in the observation group were significantly lower than those in the control group (P<0.05). There was no statistical difference of C-reaction protein (CRP) level between the two groups (P>0.05). There were statistical differences of modified Rankin Scale(mRS) [ 2.00 (1.75, 3.00) vs. 2.00 (1.00, 2.00)], neurological deficit score [3.00 (1.75, 14.50) vs. 2.00 (1.00, 3.00)], and mini-mental state examination (MMSE) scales [(20.15±5.28) points vs. (24.07±6.70) points] between the control group and observation group at the time point of discharge (P<0.05). Early application of probiotics significantly improved neurological and cognitive function at discharge.Additionally, There were statistical differences of neurological deficit score [3.00 (1.75, 5.25) points vs. 2.00 (1.75, 2.00) points] and MMSE scales [(21.90±5.66) points vs. 24.77±4.29) points] between the control group and observation group at the time point of 6-month post-discharge (P<0.05). However, there was no statistical difference of mRS scores [2.00 (1.00, 3.00) points vs. 1.00 (0.00, 2.00) points] between the control group and observation group (P>0.05). The therapeutic effect of of early application of the probiotics on neurological deficits and cognitive function improvement was still evident at the time point of 6-month post-discharge.Conclusion Early application of probiotics can decrease the circulation inflammatory levels of patients and promote the recovery of both short- and longterm neurological and cognitive functions of patients. |
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