ORIGINAL
Introdução: Esta investigação foi realizada após já terem sido realizados estudos separados sobre os efeitos individuais de cada droga na redução dos sintomas de distúrbios neurológicos que ocorrem pós-trauma. Objetivo: examinar os efeitos da combinação de eritropoietina e testosterona (EPO-TES) em pacientes traumáticos com danos neurológicos. Materiais e Métodos: foi realizado um ensaio clínico em pacientes que sofreram traumatismo cranioencefálico e obtiveram pontuação na Escala de Coma de Glasgow (ECG) inferior a 9. O estudo foi realizado no ano de 2022 em dois hospitais em Teerã, o Rasool Akram Hospital e o 7º Tir Hospital. O estudo envolveu 60 pacientes que foram divididos aleatoriamente em dois grupos. O grupo intervenção recebeu eritropoietina intravenosa na dose de 4.000 unidades, seguida de três doses por semana durante três semanas. Além disso, a testosterona foi injetada por via intramuscular uma vez por semana durante três semanas na dose de 250 mg. Antes da intervenção e uma semana após sua conclusão, o escore da ECGl dos pacientes foi avaliado. Resultados: O grupo intervenção teve uma ECG inicial de 6,16±1,57, enquanto o grupo controle teve uma ECG inicial de 5,97±1,90. No entanto, não houve diferença significativa entre a ECG inicial dos dois grupos (p=0,659). A ECG secundária no grupo de intervenção foi de 7,28 ± 4,33, maior do que a ECG pós-trauma da quarta semana do grupo controle de 3,90 ± 2,95, indicando um aumento significativo no grupo de intervenção (p=0,039). Em contraste, a ECG pós-trauma da quarta semana do grupo controle diminuiu significativamente em comparação com o estado inicial (p=0,043), enquanto no grupo intervenção, a ECG pós-trauma da quarta semana aumentou significativamente em comparação com o estado inicial (p=0,028). Apesar dessas diferenças, os resultados dos pacientes não diferiram significativamente entre os dois grupos (p=0,603). Conclusão: É possível aumentar o escore da ECGl em pacientes com dano neurológico causado por TCE usando uma combinação de EPO-TES.
Introduction: this investigation was conducted after separate studies had already been conducted on the individual effects of each drug in reducing the symptoms of neurological disorders that occur post-trauma. Objective: the current study aimed to examine the effects of combining erythropoietin and testosterone (EPO-TES) in traumatic patients with neurological damage. Methods: a clinical trial was carried out on patients who had suffered traumatic brain injury and had a Glasgow Coma Scale (GCS) score of less than 9. The study was conducted in the year 2022 at two hospitals in Tehran, namely Rasool Akram Hospital and 7th Tir Hospital. The trial involved sixty patients who were randomly divided into two groups. The intervention group received intravenous erythropoietin at a dose of 4,000 units, followed by three doses per week for three weeks. In addition, testosterone was injected intramuscularly once a week for three weeks at a dose of 250 mg. Prior to the intervention and one week following its completion, the patients’ GCS score was assessed. Results: the intervention group had an initial GCS of 6.16±1.57, while the control group had an initial GCS of 5.97±1.90. However, there was no significant difference between the initial GCS of the two groups (p=0.659). The secondary GCS in the intervention group was 7.28 ± 4.33, which was higher than the control group’s fourth-week post-trauma GCS of 3.90 ± 2.95, indicating a significant increase in the intervention group (p=0.039). In contrast, the control group’s fourth-week post-trauma GCS significantly decreased compared to the initial state (p=0.043), while in the intervention group, the fourth-week post-trauma GCS significantly increased compared to the initial state (p=0.028). Despite these differences, patient outcomes did not significantly differ between the two groups (p=0.603). Conclusion: it is possible to enhance the GCS score in patients with neurological damage caused by TBI by using a combination of EPO-TES.
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1Department of Neurosurgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
2Skull Base Research Center, Department of Neurosurgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Received Aug 4, 2024
Accepted Sept 5, 2024
