Effects of Minocycline on Neurological Outcomes In Patients With Acute Traumatic Brain Injury: A Pilot Study
Effects of Minocycline on Neurological Outcomes In Patients With Acute Traumatic Brain Injury: A Pilot Study
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DOI：
10.22037/ijpr.2019.1100677
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发表时间：
2019-03-01
影响因子：
1.6
通讯作者：
Ala, Shahram
中科院分区：
文献类型：
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作者：
Koulaeinejad, Neda;Haddadi, Kaveh;Ala, Shahram
创伤性脑损伤（TBI）是一个全球性的公共卫生问题。脑损伤的继发性损害在创伤后几分钟内开始，并可能持续很长时间。它可以是可逆的，不像原发性损伤。因此，可以使用治疗干预。本研究的目的是评估米诺环素对中重度TBI患者神经功能和血清S100 B蛋白和神经元特异性烯醇化酶（NSE）水平的影响。脑外伤急性发作和血肿清除术的患者随机接受米诺环素100 mg口服，每日两次或安慰剂7天。主要结局包括试验期间不同时间点S100 B和NSE水平的变化。此外，还评估了格拉斯哥昏迷评分（GCS）的变化。对出院患者进行伤后6个月的格拉斯哥结局量表扩展（GOS-E）评分。34例患者随机分为安慰剂组（n = 20）和治疗组（n = 14）。组间S100 B标准化值存在边缘统计学显著差异（p < 0.1）。二甲胺四环素组血清NSE水平从基线至第5天的降低具有统计学意义（p = 0.01），而安慰剂组则无显著降低（p = 0.2）。此外，二甲胺四环素组GCS随时间的改善是显著的（p = 0.04），而安慰剂组无显著性（p = 0.11）。二甲胺四环素组和安慰剂组的GOS-E评分无显著性差异。基于这项研究，米诺环素的使用似乎对急性TBI有效。
Traumatic brain injury (TBI) is a public health problem worldwide. Secondary damage of brain injury begins within a few minutes after the trauma and can last a long time. It can be reversible, unlike primary injury. Therefore, therapeutic intervention can be used. The aims of this study were to assess the effects of minocycline on neurological function and serum S100B protein and neuron-specific enolase (NSE) levels in patients with moderate to severe TBI. Patients with acute onset of TBI and surgical evacuation of hematoma were randomized to receive either minocycline 100 mg orally twice daily or placebo for 7 days. The primary outcomes included changes in level of S100B and NSE at different time points during the trial. Additionally, changes in Glasgow coma scale (GCS) score were evaluated. The Glasgow Outcome Scale-Extended (GOS-E) score at 6 months after injury was assessed in discharge patients. Thirty four patients were randomized into the placebo (n = 20) and treatment (n = 14) groups. There was a marginal statistically significant differences in the normalized value of S100B between groups (p < 0.1). The reduction in serum NSE level from baseline to day 5 was statistically significant (p = 0.01) in minocycline group while it was not significantly decrease in placebo group (p = 0.2). Also, GCS improvement over time within the minocycline group was significant (p = 0.04) while was not significant in placebo group (p = 0.11). The GOS-E scores were not significantly different between minocycline and placebo group. Based on this study, it seems that the use of minocycline may be effective in acute TBI.