Exogenous lactate infusion improved neurocognitive function of patients with mild traumatic brain injury.
Exogenous lactate infusion improved neurocognitive function of patients with mild traumatic brain injury.
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DOI：
10.4103/1793-5482.145375
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发表时间：
2016-04
期刊：
影响因子：
--
通讯作者：
Fuadi I
中科院分区：
文献类型：
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作者：
Bisri T;Utomo BA;Fuadi I
许多研究表明，在中重度创伤性脑损伤中，外源性乳酸能较好地恢复认知功能。然而，乳酸盐对轻度创伤性脑损伤疗效的评价研究仍然有限。探讨外源性乳酸对轻度外伤性脑损伤患者认知功能的影响。前瞻性、单盲、随机对照研究60例接受神经外科手术的轻度创伤性脑损伤患者。受试者随机分为高渗性乳酸钠（HSL）组和高渗性氯化钠（HSS）组。各组患者在神经外科手术前15 min内静脉滴注HSL或NaCl 3%，剂量为1.5 ml/KgBW。术中，两组患者均以1.5 ml/KgBW/h的速度维持输注0.9% NaCl。术后24小时、30天、90天用MMSE评分评估认知功能，采用方差分析重复测量检验。HSL组MMSE评分改善明显优于HSS组（P < 0.001）。HSL组MMSE评分由基线时的16.00（13.75 ~ 18.00）提高至21.00 (18.75 ~ 22.00)；25.00 (23.75 - -26.00);术后24小时、30天、90天分别为28.00（27.00-29.00）。相比之下，HSS组的MMSE评分在术后24小时几乎没有变化，仅在术后30和90天略有增加。轻度外伤性脑损伤时高渗乳酸钠输注对认知功能的改善效果比氯化钠好3%。
Many studies showed a better recovery of cognitive function after administration of exogenous lactate during moderate-severe traumatic brain injury. However, the study evaluating lactate effect on mild traumatic brain injury is still limited. To evaluate the effect of exogenous lactate on cognitive function in mild traumatic brain injury patients. Prospective, single blind, randomized controlled study on 60 mild traumatic brain injury patients who were undergoing neurosurgery. Subjects were randomly assigned into hyperosmolar sodium lactate (HSL) group or hyperosmolar sodium chloride (HSS) group. Patients in each group received either intravenous infusion of HSL or NaCl 3% at 1.5 ml/KgBW within 15 min before neurosurgery. During the surgery, patients in both groups received maintenance infusion of NaCl 0.9% at 1.5 ml/KgBW/hour. Cognitive function, as assessed by Mini-Mental State Examination (MMSE) score at 24 h, 30 and 90 days post-surgery, was analyzed by Anova repeated measures test. The MMSE score improvement was significantly better in HSL group than HSS group (P < 0.001). In HSL group the MMSE score improved from 16.00 (13.75-18.00) at baseline to 21.00 (18.75-22.00); 25.00 (23.75-26.00); 28.00 (27.00-29.00) at 24 h, 30, 90 days post-surgery, respectively. In contrast, in HSS group the MMSE score almost unchanged at 24 h and only slightly increased at 30 and 90 days post-surgery. Hyperosmolar sodium lactate infusion during mild traumatic brain injury improved cognitive function better than sodium chloride 3%.