鼠神经生长因子对脑梗死患者VEGF、BDNF、IGF-1及血清细胞因子水平的影响
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摘要
目的探析鼠神经生长因子对脑梗死患者血管内皮生长因子(VEGF)、脑源性神经营养因子(BDNF)、胰岛素样生长因子(IGF)-1及血清细胞因子水平的影响。方法采用回顾性研究方法,以2015年3月至2017年6月收治的216例急性脑梗死患者为研究对象,根据治疗方案的不同将患者分为对照组和观察组,各108例。对照组采取常规脑梗死治疗方案,观察组在对照组基础上采用肌内注射鼠神经生长因子。比较两组治疗前后神经功能缺损程度、血清VEGF、BDNF、IGF-1及血清细胞因子水平。结果治疗14 d后,两组NIHSS评分较治疗前均明显下降,且观察组明显低于对照组,差异均有统计学意义(P<0.01);两组VEGF、BDNF、IGF-1水平较治疗前均明显升高,且观察组均明显高于对照组,差异均有统计学意义(P<0.05,P<0.01);两组血清相关细胞因子白介素(IL)-1β、IL-6、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子(TNF)-α水平较治疗前均明显下降,且观察组均明显低于对照组(P<0.05,P<0.01)。结论对急性脑梗死患者应用鼠神经生长因子可显著减轻其神经损伤程度,上调患者血清VEGF、BDNF、IGF-1水平,并且对部分血清细胞因子能起到明显的抑制作用。
Objective To explore the effects of rat nerve growth factor on the levels of vascular endothelial growth factor(VEGF),brain-derived neurotrophic factor(BDNF),insulin-like growth factor-1(IGF-1) and serum cytokines in patients with cerebral infarction.Methods A total of 216 patients with acute cerebral infarction admitted to hospital from March 2015 to June 2017 were included and divided into control group and observation group(n=108,each) according to the different treatment schemes.The routine treatment of cerebral infarction was performed in control group,while the intramuscular injection of rat nerve growth factor was given based on the routine treatment in observation group.The degree of neurological deficit,serum levels of VEGF,BDNF,IGF-1 and serum cytokines were compared between two groups.Results After 14 d of treatment,the scores of National Institutes of Health Stroke Scale(NIHSS) were significantly lower than those before treatment in both groups and was statistically lower in observation group than that in control group(all P<0.05);levels of VEGF,BDNF,IGF-1 were obviously higher than those before treatment in both groups and were statistically higher in observation group than those in control group(all P<0.05);levels of serum interleukin(IL)-1β,IL-6,high sensitivity C-reactive protein(hs-CRP)and tumour necrosis factor-α(TNF-α) significantly decreased in both groups compared with before treatment and were significantly lower in observation group than those in control group(all P<0.05).Conclusion For patients with acute cerebral infarction,application of rat nerve growth factor can significantly reduce the degree of nerve injury,increase the serum levels of VEGF,BDNF and IGF-1 and inhibit the production of some serum related cytokines obviously.
Objective To explore the effects of rat nerve growth factor on the levels of vascular endothelial growth factor(VEGF),brain-derived neurotrophic factor(BDNF),insulin-like growth factor-1(IGF-1) and serum cytokines in patients with cerebral infarction.Methods A total of 216 patients with acute cerebral infarction admitted to hospital from March 2015 to June 2017 were included and divided into control group and observation group(n=108,each) according to the different treatment schemes.The routine treatment of cerebral infarction was performed in control group,while the intramuscular injection of rat nerve growth factor was given based on the routine treatment in observation group.The degree of neurological deficit,serum levels of VEGF,BDNF,IGF-1 and serum cytokines were compared between two groups.Results After 14 d of treatment,the scores of National Institutes of Health Stroke Scale(NIHSS) were significantly lower than those before treatment in both groups and was statistically lower in observation group than that in control group(all P<0.05);levels of VEGF,BDNF,IGF-1 were obviously higher than those before treatment in both groups and were statistically higher in observation group than those in control group(all P<0.05);levels of serum interleukin(IL)-1β,IL-6,high sensitivity C-reactive protein(hs-CRP)and tumour necrosis factor-α(TNF-α) significantly decreased in both groups compared with before treatment and were significantly lower in observation group than those in control group(all P<0.05).Conclusion For patients with acute cerebral infarction,application of rat nerve growth factor can significantly reduce the degree of nerve injury,increase the serum levels of VEGF,BDNF and IGF-1 and inhibit the production of some serum related cytokines obviously.
引文
[1] Sveinsson OA,Kjartansson O,Valdimarsson EM.Cerebral ischemia/infarction-epidemiology,causes and symptoms[J].Laeknabladid,2014,100(5):271-279.
[2] 梁莉莉,张振香,王盼盼.赋能在脑卒中患者护理中的研究进展及启示[J].中国实用护理杂志,2015,31(34):2650-2652.
[3] Wang Q,Zhao H,Zheng T,et al.Otoprotective effects of mouse nerve growth factor in DBA/2J mice with early-onset progressive hearing loss[J].J Neurosci Res,2017,95(10):1937-1950.
[4] 林程星,周新民,郑书杭.鼠神经生长因子联合高压氧治疗突发性聋的疗效观察[J].实用临床医药杂志,2016,20(11):214-215.
[5] 中华医学会神经病学分会.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-257.
[6] Abdul-Rahim AH,Fulton RL,Sucharew H,et al.National institutes of health stroke scale item profiles as predictor of patient outcome:external validation on independent trial data[J].Stroke,2015,46(2):395-400.
[7] Sveinsson óá,Kjartansson ó,Valdimarsson EM.Cerebral ischemia/infarction-diagnosis and treatment[J].Laeknabladid,2014,100(7/8):393-401.
[8] Gao L,Ge R,Xie G,et al.Hearing improvement in A/J mice via the mouse nerve growth factor[J].Clin Exp Otorhinolaryngol,2017,10(4):303-308.
[9] 刘丹丹,靳洪波.鼠神经生长因子治疗急性老年脑梗死疗效观察[J].现代中西医结合杂志,2016,25(16):1780-1782.
[10] 刘向红,郎玉洁.鼠神经生长因子对新生儿缺氧缺血性脑病的安全性及疗效[J].实用临床医药杂志,2015,19(13):193-194.
[11] 孙迪迪.鼠神经生长因子治疗脑梗死临床分析[J].中国实用神经疾病杂志,2016,19(18):119-120.
[12] Park SY,Kim J,Kim OJ,et al.Predictive value of circulating interleukin-6 and heart-type fatty acid binding protein for three months clinical outcome in acute cerebral infarction:multiple blood markers profiling study[J].Crit Care,2013,17(2):R45.
[13] 金岗生,冯炯,陈衍,等.急性脑梗死患者VEGF浓度变化与NIHSS评分的关系[J].中国现代医生,2016,54(19):17-20.
[14] Vacaras V,Major ZZ,Muresanu DF,et al.Effect of glatiramer acetate on peripheral blood brain-derived neurotrophic factor and phosphorylated TrkB levels in relapsing-remitting multiple sclerosis[J].CNS Neurol Disord Drug Targets,2014,13(4):647-651.
[15] Dong X,Chang G,Ji XF,et al.The relationship between serum insulin-like growth factor I levels and ischemic stroke risk[J].PLoS One,2014,9(4):e94845.
[16] 尹惠丽,高凤岩,于丽,等.鼠神经生长因子治疗急性脑梗死的疗效及对BDNF、IGF-1和IL-33水平的影响[J].药物评价研究,2017,40(7):946-949.
[17] 黄体秀,张红.鼠神经生长因子治疗新生儿缺氧缺血性脑病的临床疗效及神经保护作用[J].河北医学,2014,20(12):1956-1958.
[18] 黄年平,付栋,邓志洪.注射用鼠神经生长因子治疗老年痴呆患者的临床研究[J].中国临床药理学杂志,2017,33(6):490-492.
[19] 孔超,李丹,袁晓君,等.重组人肿瘤坏死因子蛋白TNF-α的纯化与功能鉴定[J].科技导报,2017,35(8):70-74.
[20] 姜忠梅,卢冬喜,李红霞.鼠神经生长因子辅助治疗急性脑梗死疗效观察[J].山东医药,2015,55(34):106-107.
[21] 张慧霞,常晓悦,王利军.IL-6与肺部炎性疾病关系最新进展[J].国际呼吸杂志,2015,35(1):74-78.
[22] 陈新东,朱志军,黄彦真,等.血清D-二聚体和超敏-C反应蛋白水平与脑梗死严重程度的相关性及脑梗死预后因素分析[J].广西医科大学学报,2017,34(3):375-378.
[23] 金伟敏,黄雨茅,郑戈,等.选择性头部亚低温疗法联合鼠神经生长因子治疗HIE的疗效及机制研究[J].浙江医学,2017,39(16):1337-1340.
[24] 李荣.注射用鼠神经生长因子生物学活性检测方法的研究[D].武汉:湖北大学,2014.
[2] 梁莉莉,张振香,王盼盼.赋能在脑卒中患者护理中的研究进展及启示[J].中国实用护理杂志,2015,31(34):2650-2652.
[3] Wang Q,Zhao H,Zheng T,et al.Otoprotective effects of mouse nerve growth factor in DBA/2J mice with early-onset progressive hearing loss[J].J Neurosci Res,2017,95(10):1937-1950.
[4] 林程星,周新民,郑书杭.鼠神经生长因子联合高压氧治疗突发性聋的疗效观察[J].实用临床医药杂志,2016,20(11):214-215.
[5] 中华医学会神经病学分会.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-257.
[6] Abdul-Rahim AH,Fulton RL,Sucharew H,et al.National institutes of health stroke scale item profiles as predictor of patient outcome:external validation on independent trial data[J].Stroke,2015,46(2):395-400.
[7] Sveinsson óá,Kjartansson ó,Valdimarsson EM.Cerebral ischemia/infarction-diagnosis and treatment[J].Laeknabladid,2014,100(7/8):393-401.
[8] Gao L,Ge R,Xie G,et al.Hearing improvement in A/J mice via the mouse nerve growth factor[J].Clin Exp Otorhinolaryngol,2017,10(4):303-308.
[9] 刘丹丹,靳洪波.鼠神经生长因子治疗急性老年脑梗死疗效观察[J].现代中西医结合杂志,2016,25(16):1780-1782.
[10] 刘向红,郎玉洁.鼠神经生长因子对新生儿缺氧缺血性脑病的安全性及疗效[J].实用临床医药杂志,2015,19(13):193-194.
[11] 孙迪迪.鼠神经生长因子治疗脑梗死临床分析[J].中国实用神经疾病杂志,2016,19(18):119-120.
[12] Park SY,Kim J,Kim OJ,et al.Predictive value of circulating interleukin-6 and heart-type fatty acid binding protein for three months clinical outcome in acute cerebral infarction:multiple blood markers profiling study[J].Crit Care,2013,17(2):R45.
[13] 金岗生,冯炯,陈衍,等.急性脑梗死患者VEGF浓度变化与NIHSS评分的关系[J].中国现代医生,2016,54(19):17-20.
[14] Vacaras V,Major ZZ,Muresanu DF,et al.Effect of glatiramer acetate on peripheral blood brain-derived neurotrophic factor and phosphorylated TrkB levels in relapsing-remitting multiple sclerosis[J].CNS Neurol Disord Drug Targets,2014,13(4):647-651.
[15] Dong X,Chang G,Ji XF,et al.The relationship between serum insulin-like growth factor I levels and ischemic stroke risk[J].PLoS One,2014,9(4):e94845.
[16] 尹惠丽,高凤岩,于丽,等.鼠神经生长因子治疗急性脑梗死的疗效及对BDNF、IGF-1和IL-33水平的影响[J].药物评价研究,2017,40(7):946-949.
[17] 黄体秀,张红.鼠神经生长因子治疗新生儿缺氧缺血性脑病的临床疗效及神经保护作用[J].河北医学,2014,20(12):1956-1958.
[18] 黄年平,付栋,邓志洪.注射用鼠神经生长因子治疗老年痴呆患者的临床研究[J].中国临床药理学杂志,2017,33(6):490-492.
[19] 孔超,李丹,袁晓君,等.重组人肿瘤坏死因子蛋白TNF-α的纯化与功能鉴定[J].科技导报,2017,35(8):70-74.
[20] 姜忠梅,卢冬喜,李红霞.鼠神经生长因子辅助治疗急性脑梗死疗效观察[J].山东医药,2015,55(34):106-107.
[21] 张慧霞,常晓悦,王利军.IL-6与肺部炎性疾病关系最新进展[J].国际呼吸杂志,2015,35(1):74-78.
[22] 陈新东,朱志军,黄彦真,等.血清D-二聚体和超敏-C反应蛋白水平与脑梗死严重程度的相关性及脑梗死预后因素分析[J].广西医科大学学报,2017,34(3):375-378.
[23] 金伟敏,黄雨茅,郑戈,等.选择性头部亚低温疗法联合鼠神经生长因子治疗HIE的疗效及机制研究[J].浙江医学,2017,39(16):1337-1340.
[24] 李荣.注射用鼠神经生长因子生物学活性检测方法的研究[D].武汉:湖北大学,2014.
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