目的 探讨鼠神经生长因子联合亚低温对重度创伤性颅脑损伤神经保护作用机制.方法 选取重度创伤性颅脑损伤患者90例,按随机数字表法分为对照组和研究组,分别为45例,对照组予以常规治疗,研究组在常规治疗基础上予以鼠神经生长因子联合亚低温治疗,2组共治疗2周为一疗程,于治疗前和治疗后测定神经损伤、炎症相关、氧化应激指标状况,同时对比临床疗效及并发症状况.结果 相对于治疗前,相对于对照组,研究组治疗后格拉斯哥昏迷(Glasgow coma scale,GCS)评分、格拉斯哥结局量表(Glasgow outcome scale,GOS)评分、蒙特利尔认知评估量表(montreal cognitive assessment,MoCA)评分较高,美国国立卫生院神经功能缺损(National Institute of Health stroke scale,NIHSS)评分较低(P<0.05),神经元特异性烯醇化酶(neuronspecific enolase,NSE)、髓鞘碱性蛋白(myelin basic protein,MBP)及S100β含量较低(P<0.05),血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6)、IL-10含量较低(P<0.05),丙二醛(malondialdehyde,MDA)含量降低,谷胱甘肽过氧化物酶(glutathione peroxidase,GPx)、抗氧化能力(oxidation resistance,AOA)含量较高(P<0.05);对照组有效率73.33%与研究组有效率91.11%数据对比(P<0.05);所有患者均获得随访,无病例脱落现象,2组间不良率数据对比,差异无统计学意义.结论 鼠神经生长因子联合亚低温对重度创伤性颅脑损伤神经保护作用显著,与降低神经损伤指标,改善炎症因子和氧化应激反应关系密切.
Mouse nerve growth factor and sub-hypothermia for neural protection in severe traumatic brain injury and its mechanism
Objective To investigate the mechanism of neural protection of mouse nerve growth factor combined with sub-hypothermia in the treatment of patients with severe traumatic brain injury. Methods 90 cases of severe traumatic brain injury were randomly divided into study group and control group with 45 cases of each group, the control group were given routine treatment; the study group were given on the basis of routine treatment of mouse nerve growth factor combined with sub-hypothermia treatment, with 2 weeks treatment, the clinical indicators and corresponding nerve injury, inflammation, oxidative stress indexes, clinical effect and complications were compared after 2 weeks treatment. Results Compared with before treatment or control group, scores of Glasgow coma scale (GCS) and Glasgow outcome scale (GOS) and montreal cognitive assessment (MoCA) in study group after the treatment increased, National Institute of Health stroke scale (NIHSS) score decreased(P<0.05), neuronspecific enolase (NSE), myelin basic protein (MBP) and S100 beta levels decreased(P<0.05), the serum tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6), IL-10 levels decreased (P<0.05), the malondialdehyde (MDA) decreased, the glutathione peroxidase (GPx) and oxidation resistance (AOA) levels increased (P<0.05). The control group efficiency was 73.33%, the study group efficiency was 91.11%, there was significant difference (P<0.05). All patients were followed up, no case off, there was no significant difference in adverse drug reaction rate between two groups. Conclusion Mouse nerve growth factor and sub-hypothermia has the significant neural protection for patients with severe traumatic brain injury, and its mechanism may be related to reduce nerve injury indicators and improve inflammatory factor and oxidative stress response.
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万方数据
维普
