A Study Of The Effects Of TNF-α And Magnesium Treatment's Influence In The Patients With STBI

ackground:severe traumatic brain injury(sTBI) is a important issue and difficult to be resolved in the field of neurosurgery,which has a very high mortality and morbidity,and has become a severe threaten to human health.It is now recognized that neuronal cell death resulting from TBI is caused through both primary and secondary injury mechanisms,and prevent the secondary injury is the key to improve sTBI's outcome.Magnesium may affect multiple injury factors and attenuate secondary injury and has been focused on.Magnesium can reduce the serum concentration of TNF-α.Object:To observe the serum dynamic change on concentration of tumor necrosis factor-α(TNF-α) of the patients with severe traumatic brain injury (sTBI),and to analyze the influence of early inhibiting the inflammatory reaction by magnesium on them.And research part of mechanism of magnesium's effect.Methods:60 patients with sTBI were divided into two groups:routine treatment group and magnesium treatment groups.After episode,elbow venous blood were collected in the morning on the first day,third day and seven day respectively.In the magnesium treatment group,persons were given intravenous MgSO4,which was initiated with a bolus of 2.5g over 15 minutes,followed by continuous infusion at 0.4g/hour(10g/day) for 7 days.In routine treatment group,clinical management principles were the same as magnesium treatment group except MgSO4.Daily serum Mg and TNF-αwere monitored,and clinical outcomes were valued using the Glasgow Outcome Scale score(GOSs) at 3 months after injury.Results:magnesium treatment group The serum concentration of TNF-αraised on the first day after admission,and it was highest on the third day,on the seven day it was still higher than the first day.Decreased serum TNF-αwere observed in the patients with magnesium treatment group compared to routine treatment group(P ＜0.05).There was a slight but not significantly lower GOS score in magnesium treatment group compared to routine treatment group.Conclusion:Proinflammatory cytokine TNF-αis associated with the early inflammatory course of patiens with sTBI.Magnesium can reduce the serum concentration of TNF-α.Mg has a role as a neuroprotective agent,and there is a trend of improving these patients' outcome.