鼠神经生长因子治疗老年脑出血临床疗效及对患者血清NSE、hs-CRP、TNF-α、IL-8、MMP-9影响
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摘要
目的探析鼠神经生长因子(mNGF)治疗老年脑出血临床疗效及对患者血清神经元特异性烯醇化酶(NSE)、白介素(IL)-8、肿瘤坏死因子(TNF)-α、超敏C反应蛋白(hs-CRP)、金属基质蛋白酶(MMP)-9和生活质量影响。方法选取本院2017年5月至2018年6月收治的老年脑出血患者58例,双盲法数字随机分组,对照组(29例)给予降血压、营养细胞、依达拉奉及尼莫地平等常规用药,观察组(29例)则常规用药基础联合m NGF治疗,比较两组血清神经元特异性烯醇化酶(NSE)、炎性因子,评价临床疗效及生活质量。结果两组治疗4w后hs-CRP、TNF-α、IL-8、MMP-9、NSE、NIHSS评分、血肿量及水肿面积均明显低于治疗前(P<0.05),且观察组hs-CRP、TNF-α、IL-8、MMP-9、NSE、NIHSS评分、血肿量及水肿面积改善幅度明显优于对照组(P<0.05);观察组治疗有效率明显高于对照组(P<0.05)。两组治疗4w后Barthel指数、SIS评分均明显高于治疗前(P<0.05),且观察组Barthel指数、SIS评分提高幅度明显优于对照组(P<0.05)。结论老年脑出血患者采取m NGF治疗效果良好,可减轻炎症反应,血肿吸收及缓解水肿,促进神经功能恢复,改善生活质量。
Objective To investigate the clinical effect of mousenerve growth factor(mNGF) in the treatment of senile intracerebral hemorrhage and the serum neuron specific enolase(NSE), interleukin(IL)-8 and tumor necrosis factor(TNF)-α. Effects of hypersensitive C reactive protein(hs-CRP), metalloproteinase(MMP)-9 and quality of life. Method From May 2017 to June 2018, 58 elderly patients with intracerebral hemorrhage were randomly divided into two groups. The control group(29 cases) was given lowering blood pressure,controlling intracranial pressure and nutritive cells. Edaravone and nimodipine were used routinely, while in the observation group(29 cases), routine therapy was combined with mNGF. The serum neuron-specific enolase(NSE),inflammatory factors were compared between the two groups, and the clinical efficacy and quality of life were evaluated.Results after 4 weeks of treatment, the scores of hs-CRP, TNF-α,-IL-8, MMP-9, NSE, NIHSS, hematoma volume and edema area in the two groups were significantly lower than those before treatment(P<0.05). The hsCRP, TNF-α, IL-8, MMP-9, NSE, NNIHSS score, hematoma volume and edema area in the observation group were significantly better than those in the control group(P<0.05). The effective rate of treatment in the observation group was significantly higher than that in the control group(P<0.05). After 4 weeks of treatment, the Barthel index score of the two groups was significantly higher than that of the control group(P<0.05), and that of the observation group was significantly better than that of the control group(P<0.05). Conclusion mNGF can reduce inflammation,eliminate hematoma and edema, promote the recovery of nerve function and improve the quality of life in elderly patients with intracerebral hemorrhage.
Objective To investigate the clinical effect of mousenerve growth factor(mNGF) in the treatment of senile intracerebral hemorrhage and the serum neuron specific enolase(NSE), interleukin(IL)-8 and tumor necrosis factor(TNF)-α. Effects of hypersensitive C reactive protein(hs-CRP), metalloproteinase(MMP)-9 and quality of life. Method From May 2017 to June 2018, 58 elderly patients with intracerebral hemorrhage were randomly divided into two groups. The control group(29 cases) was given lowering blood pressure,controlling intracranial pressure and nutritive cells. Edaravone and nimodipine were used routinely, while in the observation group(29 cases), routine therapy was combined with mNGF. The serum neuron-specific enolase(NSE),inflammatory factors were compared between the two groups, and the clinical efficacy and quality of life were evaluated.Results after 4 weeks of treatment, the scores of hs-CRP, TNF-α,-IL-8, MMP-9, NSE, NIHSS, hematoma volume and edema area in the two groups were significantly lower than those before treatment(P<0.05). The hsCRP, TNF-α, IL-8, MMP-9, NSE, NNIHSS score, hematoma volume and edema area in the observation group were significantly better than those in the control group(P<0.05). The effective rate of treatment in the observation group was significantly higher than that in the control group(P<0.05). After 4 weeks of treatment, the Barthel index score of the two groups was significantly higher than that of the control group(P<0.05), and that of the observation group was significantly better than that of the control group(P<0.05). Conclusion mNGF can reduce inflammation,eliminate hematoma and edema, promote the recovery of nerve function and improve the quality of life in elderly patients with intracerebral hemorrhage.
引文
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[12]Salih C,Sefer V,Ozdemir H H,et al.Association of brain-derived neurotrophic factor and nerve growth factor gene polymorphisms with susceptibility to migraine:[J].Neuropsychiatr Dis Treat,2016,12:1779-1785.
[13]Tawk R G,Grewal S S,Heckman M G,et al.The relationship between serum neuron-specific enolase levels and severity of bleeding and functional outcomes in patients with nontraumatic subarachnoid hemorrhage[J].Neurosurgery,2016,78(4):487-491.
[14]Jr B J,Thelin E P,Ghatan P H,et al.Neuron-specific enolase is correlated to compromised cerebral metabolism in patients suffering from acute bacterial meningitis;an observational cohort study[J].PLOS One,2016,11(3):e0152268.
[15]Li Z,He Q,Zhai X,et al.Foxo1-mediated inflammatory response after cerebral hemorrhage in rats[J].Neurosci Lett,2016,26(629):131-136.
[16]Fu G,Wang H,Cai Y,et al.Theaflavin alleviates inflammatory response and brain injury induced by cerebral hemorrhage via inhibiting the nuclear transcription factor kappaβ-related pathway in rats[J].Drug Des Devel Ther,2018,12(12):1609-1619.
[17]Song J,Liu Z,Sui L,et al.Dynamic expression of nerve growth factor and its receptor TrkA after subarachnoid hemorrhage in rat brain[J].Neural Regen Res,2016,11(8):1278-1284.
[2]Xiong L,Boulouis G,Charidimou A,et al.Dementia incidence and predictors in cerebral amyloid angiopathy patients without intracerebral hemorrhage[J].J Cereb Blood Flow Metab,2018,38(2):241-249.
[3]Lee J H,Sung Y B,Jang S H.Nerve growth factor expression in stroke induced rats after shockwave[J].J Phys Ther Sci,2016,28(12):3451-3453.
[4]Colangelo A M,Bianco M R,Vitagliano L,et al.A new nerve growth factor-mimetic peptide active on neuropathic pain in rats[J].JNeurosci,2016,28(11):2698-2709.
[5]全国第四届脑血管病学术会议.各类脑血管病诊断要点[J].中华神经科杂志,1996,29(6):379-380.
[6]蔡业峰,贾真,李伟峰,等.中文版Barthel指数对多中心测评缺血性卒中患者预后的研究[J].中国脑血管病杂志,2007,4(11):486-490.
[7]Brando A D,Teixeira N B,Brand悖O M C,et al.Translation and cultural adaptation of the stroke impact scale 2.0(SIS):a qualityoflife scale for stroke[J].Sao Paulo Med J,2018,136(2):144-149.
[8]中华神经科学会.脑卒中患者临床神经功能缺损程度评分标准[J].中华神经科杂志,1996,29(6):381-383.
[9]Martorana F,Gaglio D,Bianco M R,et al.Differentiation by nerve growth factor(NGF)involves mechanisms of crosstalk between energy homeostasis and mitochondrial remodeling[J].Cell Death Dis,2018,9(3):391.
[10]Badowskaszalewska E,Ludkiewicz B,Krawczyk R,et al.Age-related(aged vs.adult)comparison of the effect of two mild Stressors on the nerve growth factor(NGF)in the rat hypothalamic supraoptic nucleus(SON)-immunohistochemical study.[J].Folia Biol(Praha),2016,62(6):212-219.
[11]Matsuyama A,Takatori S,Sone Y,et al.Effect of nerve growth factor on innervation of perivascular nerves in neovasculatures of mouse cornea.[J].Biol Pharm Bull,2017,40(4):396-401.
[12]Salih C,Sefer V,Ozdemir H H,et al.Association of brain-derived neurotrophic factor and nerve growth factor gene polymorphisms with susceptibility to migraine:[J].Neuropsychiatr Dis Treat,2016,12:1779-1785.
[13]Tawk R G,Grewal S S,Heckman M G,et al.The relationship between serum neuron-specific enolase levels and severity of bleeding and functional outcomes in patients with nontraumatic subarachnoid hemorrhage[J].Neurosurgery,2016,78(4):487-491.
[14]Jr B J,Thelin E P,Ghatan P H,et al.Neuron-specific enolase is correlated to compromised cerebral metabolism in patients suffering from acute bacterial meningitis;an observational cohort study[J].PLOS One,2016,11(3):e0152268.
[15]Li Z,He Q,Zhai X,et al.Foxo1-mediated inflammatory response after cerebral hemorrhage in rats[J].Neurosci Lett,2016,26(629):131-136.
[16]Fu G,Wang H,Cai Y,et al.Theaflavin alleviates inflammatory response and brain injury induced by cerebral hemorrhage via inhibiting the nuclear transcription factor kappaβ-related pathway in rats[J].Drug Des Devel Ther,2018,12(12):1609-1619.
[17]Song J,Liu Z,Sui L,et al.Dynamic expression of nerve growth factor and its receptor TrkA after subarachnoid hemorrhage in rat brain[J].Neural Regen Res,2016,11(8):1278-1284.