Clinical effects of recombinant human erythropoietin combined with naloxone in treatment of coma patients post severe craniocerebral trauma

Zhang Xin; Zhao Ziping; Zheng Junqing

doi:10.3760/cma.j.issn.1673-4777.2015.03.017

Abstract：Objective To study the clinical effect of recombinant human erythropoietin combined with naloxone on coma patients post severe craniocerebral trauma.Methods A total of 80 consecutive comas patients of severe craniocerebral trauma with Glasgow coma scale (GCS) score of 3-8 in Beijing Chaoyang Emergency Medical Center from March 2013 to May 2014 were enrolled and randomly divided into observation group (40 cases) and control group (40 cases).Conventional treatments including life care,bemostasia,lowering intracranial pressure and antiinfection were given in both groups.In addition,the patients in control group received intravenous injection of naloxone and the patients in observation group received erythropoietin (subcutaneous injection) combined with naloxone.The GCS score,waking-up time,effective rate,levels of inerleukin (IL)-10,high sensitivity C reactive protein (hs-CRP) and area of cerebral infarction were compared between the two groups before and after treatment.Results The GCS score in observation group after treatment was significantly increased compared with that before treatment [(12.8 ± 7.9) scores vs (5.2 ± 2.6) scores] ; it was also higher than that in control group [(9.7 ± 5.5) scores,P ＜ 0.05].The waking-up time in observation group was significantly less than that in control group [(3.1 ±1.4)d vs (5.2 ±2.3)d],and the total efficacy rate of observation group was significantly higher than that of control group [70.0％ (28/40) vs 60.0％ (24/40)] (both P ＜0.05).After treatment,in observation group,the IL-10 was higher,the hs-CRP was lower and the infarction area was smaller than those in control group [IL-10:(5.6 ± 1.2) mmol/L vs (2.7 ± 0.5) mmol/L,hs-CRP:(1.3 ± 0.5)mg/L vs (3.9 ±1.5)mg/L,infarction area:(1.9±0.3)cm2 vs (2.7 ±0.8)cm2](all P＜0.05).Conclusions Erythropoietin combined with naloxone can further improve clinical effect and prognosis of coma patients post severe craniocerebral trauma compared with single application of naloxone.