小牛血清去蛋白注射液联合高压氧对急性脑梗死患者神经功能的影响
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摘要
目的探讨小牛血清去蛋白注射液联合高压氧对急性脑梗死患者神经功能及血清血管内皮生长因子(VEGF)、基质金属蛋白酶(MMP-9)、碱性成纤维细胞生长因子(BDNF)水平变化的影响。方法选取2015年1月～2017年4月本院急性脑梗死患者92例,根据随机数表法分为2组,每组46例。对照组予以小牛血清去蛋白注射液治疗,实验组予以小牛血清去蛋白注射液+高压氧治疗。疗程结束后,观察记录两组治疗效果、不良反应情况,并对比两组治疗前后神经功能评分、血清VEGF、MMP-9、BDNF水平及生活质量变化情况。结果实验组治疗总有效率93.48%(43/46)高于对照组78.26%(36/46),差异有统计学意义(P<0.05);相比对照组,治疗后实验组NIHSS评分较低,生理功能、精力、精神状态、健康状况评分均较高,差异有统计学意义(P<0.05);相比对照组,治疗后实验组血清VEGF、BDNF水平较高,MMP-9水平较低,差异有统计学意义(P<0.05);实验组不良反应率19.57%(9/46)与对照组15.22%(7/46)相比,差异无统计学意义(P>0.05)。结论联合采用小牛血清去蛋白注射液、高压氧治疗急性脑梗死,可明显降低血清MMP-9水平,有效提高VEGF、BDNF水平,显著改善患者神经功能及生活质量,进一步提高治疗效果,且安全性较高。
Objective To investigate the effect of deproteinized calf serum injection(DCSI) combined with hyperbaric oxygen on neurological function and serum levels of vascular endothelial growth factor(VEGF),matrix metalloproteinases(MMP-9) and basic fibroblast growth factor(BDNF) in patients with acute cerebral infarction(ACI). Methods Ninety two patients with ACI in the hospital were selected in the last two years and divided into 2 groups,46 cases in each. The control group was given DCSI only whereas the experimental group was treated with both DCSI and hyperbaric oxygen. The treatment efficacy and adverse reactions were recorded. The neurological function score,serum levels of VEGF,MMP-9,BDNF and quality of life were compared between the two groups pre-and post-treatment. Results The total effective rate of the experimental group was 93.48%(43/46),which was higher than that of the control group(78.26%,36/46)(P <0.05). The scores of NIHSS in the experimental group were lower while physiological function,energy,mental state and health status were higher than those in the control(P <0.0 5). The levels of serum VEGF and BDNF in the experimental group were elevated whereas MMP-9 was decreased(P <0.05). No significant difference of the adverse reactions was seen between in the experimental(19.57%,9/46) and control groups(15.22%,7/46)(P >0.05).Conclusion Deproteinized calf serum injection combined with hyperbaric oxygen in the treatment of acute cerebral infarction can obviously decrease the levels of MMP-9 and VEGF,effectively elevate the level of BDNF,and improve the neurological functions and the quality of life of patients with acute cerebral infarction.
Objective To investigate the effect of deproteinized calf serum injection(DCSI) combined with hyperbaric oxygen on neurological function and serum levels of vascular endothelial growth factor(VEGF),matrix metalloproteinases(MMP-9) and basic fibroblast growth factor(BDNF) in patients with acute cerebral infarction(ACI). Methods Ninety two patients with ACI in the hospital were selected in the last two years and divided into 2 groups,46 cases in each. The control group was given DCSI only whereas the experimental group was treated with both DCSI and hyperbaric oxygen. The treatment efficacy and adverse reactions were recorded. The neurological function score,serum levels of VEGF,MMP-9,BDNF and quality of life were compared between the two groups pre-and post-treatment. Results The total effective rate of the experimental group was 93.48%(43/46),which was higher than that of the control group(78.26%,36/46)(P <0.05). The scores of NIHSS in the experimental group were lower while physiological function,energy,mental state and health status were higher than those in the control(P <0.0 5). The levels of serum VEGF and BDNF in the experimental group were elevated whereas MMP-9 was decreased(P <0.05). No significant difference of the adverse reactions was seen between in the experimental(19.57%,9/46) and control groups(15.22%,7/46)(P >0.05).Conclusion Deproteinized calf serum injection combined with hyperbaric oxygen in the treatment of acute cerebral infarction can obviously decrease the levels of MMP-9 and VEGF,effectively elevate the level of BDNF,and improve the neurological functions and the quality of life of patients with acute cerebral infarction.
引文
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2 王少君,孙鹃鹏,赖红义,等.强化他汀联合重组型组织纤溶酶原激活剂治疗急性脑梗死的疗效及安全性[J].中国老年学杂志,2017,37(15):3741-3743.
3 王承明,卢志刚.醒脑静注射液对老年急性脑梗死血瘀证患者的疗效及血液流变学的影响[J].中国老年学杂志,2017,37(12):2910-2912.
4 俞宁,李通,陈琼珍.早期高压氧治疗对急性脑梗死患者脑能量代谢及疗效的影响[J].卒中与神经疾病,2014,21(1):48-50.
5 杨鹰,高光凯,吴镝,等.高压氧联合小牛血去蛋白提取物注射液治疗高血压脑出血的疗效分析[J].生物医学工程与临床,2016,20(1):63-67.
6 朱红星,王晓英.小牛血清去蛋白注射液治疗高龄急性脑梗死的疗效观察[J].中国处方药,2014,18(7):72-73.
7 曾海财,林桂英.针灸联合小牛血清去蛋白提取物注射液治疗脑梗死疗效观察[J].现代中西医结合杂志,2015,28(28):3112-3114.
8 中华医学会全国第四届脑血管病学术会议.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29(26):379-382.
9 Zhao L,Hu F X.α-Lipoic acid treatment of aged type 2 diabetes mellitus complicated with acute cerebral infarction.[J].Eur Rev Med Pharmacol Sci,2014,18(23):3715-3719.
10 徐浩,洪冰,梁海燕.氯吡格雷与阿托伐他汀联合治疗老年急性脑梗死的有效性及安全性评价[J].中国医师进修杂志,2014,37(4):44-46.
11 梁允强,陈石伙,严清华,等.老年人急性脑梗死应用单唾液酸四己糖神经节苷脂治疗的效果和安全性[J].齐齐哈尔医学院学报,2016,37(36):4547-4548.
12 申丽红,梁小乐,高旭光.急性脑梗死患者微栓子与颈动脉粥样硬化斑块的相关性研究[J].中华老年心脑血管病杂志,2014,16(3):237-239.
13 张全新.大剂量阿托伐他汀治疗急性脑梗死患者的疗效观察[J].中华老年心脑血管病杂志,2014,16(8):843-845.
14 张晓锋.丁苯酞软胶囊联合依达拉奉治疗急性脑梗死的疗效分析[J].中国现代药物应用,2014,31(12):1607-1609.
15 Camerlingo M,Tudose V,Tognozzi M,et al.Predictors of re-canalisation in acute cerebral infarction from occlusion of the terminal internal carotid artery or of the middle cerebral artery mainstem treated with thrombolysis[J].Int J Neurosci,2014,124(3):199-203.
16 陈颖青,何超明.奥扎格雷钠联合去蛋白小牛血清治疗急性脑梗死疗效观察[J].中国热带医学,2014,14(4):498-500.
17 赵欢,杨东东,郭强.小牛血清去蛋白注射液治疗脑梗死疗效观察[J].新乡医学院学报,2016,33(2):123-125.
18 林文翠,林康,王景,等.高压氧配合药物治疗急性脑梗塞的临床分析[J].海南医学院学报,2015,21(8):1131-1133.
19 史福平,王惠凌,邸卫英,等.急性脑梗死患者MMP-9和VEGF的动态变化及其意义[J].临床医学,2014,34(1):3-5.
20 Lin A,Shou J,Xueyuan L I,et al.Metabolic changes in acute cerebral infarction:Findings from proton magnetic resonance spectroscopic imaging[J].Exp Ther Med,2014,7(2):451-455.
21 王培培,王雪丹,刘凤丽,等.依达拉奉对急性脑梗死患者血清BDNF水平影响及疗效的多中心研究[J].中国生化药物杂志,2015,35(2):137-139.
2 王少君,孙鹃鹏,赖红义,等.强化他汀联合重组型组织纤溶酶原激活剂治疗急性脑梗死的疗效及安全性[J].中国老年学杂志,2017,37(15):3741-3743.
3 王承明,卢志刚.醒脑静注射液对老年急性脑梗死血瘀证患者的疗效及血液流变学的影响[J].中国老年学杂志,2017,37(12):2910-2912.
4 俞宁,李通,陈琼珍.早期高压氧治疗对急性脑梗死患者脑能量代谢及疗效的影响[J].卒中与神经疾病,2014,21(1):48-50.
5 杨鹰,高光凯,吴镝,等.高压氧联合小牛血去蛋白提取物注射液治疗高血压脑出血的疗效分析[J].生物医学工程与临床,2016,20(1):63-67.
6 朱红星,王晓英.小牛血清去蛋白注射液治疗高龄急性脑梗死的疗效观察[J].中国处方药,2014,18(7):72-73.
7 曾海财,林桂英.针灸联合小牛血清去蛋白提取物注射液治疗脑梗死疗效观察[J].现代中西医结合杂志,2015,28(28):3112-3114.
8 中华医学会全国第四届脑血管病学术会议.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29(26):379-382.
9 Zhao L,Hu F X.α-Lipoic acid treatment of aged type 2 diabetes mellitus complicated with acute cerebral infarction.[J].Eur Rev Med Pharmacol Sci,2014,18(23):3715-3719.
10 徐浩,洪冰,梁海燕.氯吡格雷与阿托伐他汀联合治疗老年急性脑梗死的有效性及安全性评价[J].中国医师进修杂志,2014,37(4):44-46.
11 梁允强,陈石伙,严清华,等.老年人急性脑梗死应用单唾液酸四己糖神经节苷脂治疗的效果和安全性[J].齐齐哈尔医学院学报,2016,37(36):4547-4548.
12 申丽红,梁小乐,高旭光.急性脑梗死患者微栓子与颈动脉粥样硬化斑块的相关性研究[J].中华老年心脑血管病杂志,2014,16(3):237-239.
13 张全新.大剂量阿托伐他汀治疗急性脑梗死患者的疗效观察[J].中华老年心脑血管病杂志,2014,16(8):843-845.
14 张晓锋.丁苯酞软胶囊联合依达拉奉治疗急性脑梗死的疗效分析[J].中国现代药物应用,2014,31(12):1607-1609.
15 Camerlingo M,Tudose V,Tognozzi M,et al.Predictors of re-canalisation in acute cerebral infarction from occlusion of the terminal internal carotid artery or of the middle cerebral artery mainstem treated with thrombolysis[J].Int J Neurosci,2014,124(3):199-203.
16 陈颖青,何超明.奥扎格雷钠联合去蛋白小牛血清治疗急性脑梗死疗效观察[J].中国热带医学,2014,14(4):498-500.
17 赵欢,杨东东,郭强.小牛血清去蛋白注射液治疗脑梗死疗效观察[J].新乡医学院学报,2016,33(2):123-125.
18 林文翠,林康,王景,等.高压氧配合药物治疗急性脑梗塞的临床分析[J].海南医学院学报,2015,21(8):1131-1133.
19 史福平,王惠凌,邸卫英,等.急性脑梗死患者MMP-9和VEGF的动态变化及其意义[J].临床医学,2014,34(1):3-5.
20 Lin A,Shou J,Xueyuan L I,et al.Metabolic changes in acute cerebral infarction:Findings from proton magnetic resonance spectroscopic imaging[J].Exp Ther Med,2014,7(2):451-455.
21 王培培,王雪丹,刘凤丽,等.依达拉奉对急性脑梗死患者血清BDNF水平影响及疗效的多中心研究[J].中国生化药物杂志,2015,35(2):137-139.