[Clinical study on the therapeutic effects and mechanism of progesterone in the treatment for acute severe head injury].
OBJECTIVE
To evaluate the therapeutic effects of Progesterone (PG) on the patients with acute severe traumatic brain injury, and investigate it's neuroprotective mechanisms.


METHODS
Fifth-six patients with acute severe traumatic head injury were divided randomly into two groups: 26 cases were treated with PG and 30 cases were control. Neurological outcome of the patients were assessed using Glasgow Coma Scale (GCS), Glasgow Outcome Scale (GOS), verbal and motor functions scale and Karnofsky Performance Scale (KPS). The serum concentrations of PG, TNF-alpha and 15-F(2t)-isoprostane were measured at day 1, 5 and 10 after trauma.


RESULTS
In the two groups, There were no significant difference in the mortality, GCS of acute healing phase, GOS and verbal and motor functions at 10th days after treatment (P>0.05); After follow-up for 3 months, GOS, verbal functions and KPSin the PG treatment group were better than those in the control group (P<0.05); In addition, there was no difference of motor functions in the two groups (P>0.05). At 5th day after trauma, serum 15-F(2t)-isoprostane and TNF-alpha levels increased in the control group, but decreased at 10th day after trauma. Compared with the control group serum PG levels increased, serum 15-F(2t)-isoprostane and TNF-alpha levels reduced significantly in the PG treatment group at 5th and 10th day after injury (P<0.05).


CONCLUSIONS
It indicated that successive early application of PG will benefit the patients with acute severe head injury by improving the recovery and reducing the disability, which may be related to its alleviating inflammatory and lipid peroxidation response.
Xiao
Guo-min
GM
Department of Neurosurgery, Second People's Hospital of Hangzhou, Hangzhou 310015, China. xgm@zjedu.org
Wei
Jing
J
Wu
Zheng-hu
ZH
Wang
Wei-min
WM
Jiang
Qi-zhou
QZ
Cheng
Jun
J
Lu
Feng
F
Wu
Jian-yue
JY
Xu
Hai-song
HS
Fang
Rong
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D006259:Craniocerebral Trauma / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011374:Progesterone / Q000097:blood / Q000627:therapeutic use*; D011372:Progestins / Q000627:therapeutic use*; D011446:Prospective Studies; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D011372:Progestins; D014409:Tumor Necrosis Factor-alpha; D011374:Progesterone