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神經生長因子對重型顱腦損傷患者的治療效果及血清MMP-2、NSE 影響研究

發布日期:2017-02-10 點擊次數:8314 字體顯示:【大】  【中】  【小】

神經生長因子對重型顱腦損傷患者的治療效果及血清MMP-2、NSE 影響研究

【作者】 繆一艇,童凌云,王勇,馬為眾,張華暹,金鵬程

【Author】 MIAO Yi-ting,TONG Ling-yun,WANG Yong,et al.

【作者單位】 溫州市人民醫院神經外科

 

【摘要】 目的 探究神經生長因子對重型顱腦損傷患者的治療效果及血清基質金屬蛋白酶-2(MMP-2)、血清神經元特異性烯醇化酶(NSE)水平影響研究,以為重型顱腦損傷患者的治療提供參考。方法 分析2014 年6 月—2015 年12 月91 例在溫州市人民醫院接受治療的重癥顱腦損傷患者的臨床資料,對照組(44 例)給予常規對癥治療,觀察組(47 例)在常規治療基礎上增加鼠神經生長因子進行治療。比較2 組患者治療前后血清MMP-2、NSE水平、GCS 評分及不良發應發生率的差異。結果 觀察組患者治療14 d 后血清中MMP-2、NSE 水平明顯低于治療前水平,觀察組治療14 d 后MMP-2 明顯高于對照組,觀察組治療14 d 后NSE 水平低于對照組,差異均具有統計學意義(P < 0. 05);2 組患者治療14 d 后GCS 評分明顯高于治療前,觀察組患者治療14 d 后GCS 評分顯著高于對照組,差異均具有統計學意義(P < 0. 05);治療2 周后,觀察組患者中出現惡心、嘔吐3 例,頭暈2 例,下肢疼痛2 例,不良反應率14. 89%,對照組中惡心、嘔吐2 例,頭暈1 例,心率失常1 例,不良反應率9. 09%,2 組患者不良反應發生率比較,差異不具有統計學意義(χ2 = 0. 720,P = 0. 396)。結論 神經生長因子可明顯降低血清中MMP-2、NSE 水平,有助于患者神經功能的恢復,安全性較好。

【Abstract】Objective To investigate the curative effect of nerve growth factor on severe craniocerebral injury and its influence on the levels of matrix metalloproteinase-2(MMP-2) and neuron-specific enolase(NSE),to provide reference for the treatment of patients with severe craniocerebral injury. Methods The clinical data of 91 cases of severe craniocerebral injury in our hospital between June,2014 and December,2015 was reviewed. The control group(44 cases) received conventional symptomatic treatment,while the observation group(47 cases) received additional nerve growth factor treatment on the basis of conventional treatment. The levels of serum NSE and MMP-2,GCS score and the incidence of adverse incidence before and after the treatment were compared between the two groups. Results The serum level of MMP-2 and NSE at 14 d after the treatment in observation group was significantly lower than that before the treatment,the level of MMP-2 at d 14 after the treatment in the observation group was obviously higher than that in the control group,while the level of NSE at 14 d after the treatment in the observation group was lower than that in the control group,the difference was all statistically significant(P < 0. 05);GCS score of 14 days after treatment in Two groups was significantly higher than before treatment,GCS score at 14 d after the treatment in the observation group was significantly greater than that in the control group,the difference was statistically significant(P < 0. 05);After two weeks of treatment,the incidence of adverse reaction in the observation group was 14. 89% (nausea and vomiting in 3 cases,dizziness in 2 cases,and lower extremity pain in 2 cases) and in the control group was 9. 09% (nausea and vomiting in 2 cases,dizziness in 1 cases,and arrhythmia in 1 cases),there were no statistically significant difference(χ2 = 0. 720,P = 0. 396). Conclusion The nerve growth factor can obviously reduce the serum level of MMP-2 and NSE,and contribute to the recovery of neural function with a good security.

【關鍵詞】 神經生長因子;顱腦損傷;基質金屬蛋白酶-2;血清神經元特異性烯醇化酶

【Keywords】Nerve growth factor;Craniocerebral injury;Matrix metalloproteinase-2;Neuron-specific enolase

DOI: 10.16766 /j. cnki.issn.1674-4152.2016.12.021

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