CAJ | 학술논문

目的：探讨神经生长因子对重型颅脑损伤患者血清神经元特异性烯醇化酶(NSE)和超敏C反应蛋白(hs-CRP)水平的影响及疗效观察。方法选择68例重型颅脑损伤患者,随机分为观察组和对照组。两组患者均予以常规内科治疗(保持呼吸道通畅、降低颅内压、止血、维持水电质平衡及营养支持等),有手术指征的及时手术治疗。治疗组在此治疗的基础上加用神经生长因子18μg皮下注射,每日1次,疗程2周。观察两组治疗后的效果及药物不良反应,并比较治疗前后血清NSE和hs-CRP水平的变化。结果治疗2周后,观察组和对照组患者格拉斯哥昏迷评分[(12.45±1.81)、(10.48±1.37)分]均较治疗前[(7.52±1.34)、(7.49±1.38)分]明显改善(P约0.01或P约0.05),观察组的改善幅度大于对照组(P约0.05)；两组患者血清NSE和hs-CRP水平[(18.76±4.68)μg/L、(28.56±6.71)μg/L、(11.68±3.67)mg/L、(17.58±4.11)mg/L]均较治疗前[(35.89±7.52)μg/L、(35.94±8.01)μg/L、(25.64±5.34)mg/L、(25.19±5.62)mg/L]明显下降(P约0.05或P约0.01),观察组下降幅度大于对照组(P约0.05)。两组患者药物不良反应发生率比较差异无统计学意义(字2=0.18,P跃0.05)。结论神经生长因子治疗重型颅脑损伤患者能有效地提高治疗效果,具有良好的脑保护作用,其作用机制与降低血清NSE和hs-CRP水平密切相关。
목적：탐토신경생장인자대중형로뇌손상환자혈청신경원특이성희순화매(NSE)화초민C반응단백(hs-CRP)수평적영향급료효관찰。방법선택68례중형로뇌손상환자,수궤분위관찰조화대조조。량조환자균여이상규내과치료(보지호흡도통창、강저로내압、지혈、유지수전질평형급영양지지등),유수술지정적급시수술치료。치료조재차치료적기출상가용신경생장인자18μg피하주사,매일1차,료정2주。관찰량조치료후적효과급약물불량반응,병비교치료전후혈청NSE화hs-CRP수평적변화。결과치료2주후,관찰조화대조조환자격랍사가혼미평분[(12.45±1.81)、(10.48±1.37)분]균교치료전[(7.52±1.34)、(7.49±1.38)분]명현개선(P약0.01혹P약0.05),관찰조적개선폭도대우대조조(P약0.05)；량조환자혈청NSE화hs-CRP수평[(18.76±4.68)μg/L、(28.56±6.71)μg/L、(11.68±3.67)mg/L、(17.58±4.11)mg/L]균교치료전[(35.89±7.52)μg/L、(35.94±8.01)μg/L、(25.64±5.34)mg/L、(25.19±5.62)mg/L]명현하강(P약0.05혹P약0.01),관찰조하강폭도대우대조조(P약0.05)。량조환자약물불량반응발생솔비교차이무통계학의의(자2=0.18,P약0.05)。결론신경생장인자치료중형로뇌손상환자능유효지제고치료효과,구유량호적뇌보호작용,기작용궤제여강저혈청NSE화hs-CRP수평밀절상관。
Objective To discuss influence and curative effect observation of nerve growth factor (NGF) on serum neuron-specific enolase (NSE) and high-sensitivity C-reactive protein (hs-CRP) levels of patients with severe traumatic brain injury. Methods 68 cases of patients with severe traumatic brain injury were selected and divided into observation group and control group at random. The patients in two groups were given routine medical treatment (maintenance of air-way open, decreasing intracranial pressure, hemostasis, maintenance of water-electrolyte balance, nutrition supporting and other medical treatment) and timely surgical treatment on patients with surgical indications. The patients in treat-ment group were additionally 18 μg NGF by hypodermic injection, once for daily, with 2 weeks' course of treatment. The curative effect and drug adverse reaction (DAR) of patients in two groups after the medical treatment were ob-served, and the changes of serum NSE and hs-CRP levels before and after medical treatment were compared as well. Results After 2 weeks' treatment, the GCS scores of patients in two groups [(12.45±1.81), (10.48±1.37) scores] were im-proved than before [(7.52±1.34), (7.49±1.38) scores] (P<0.01 or P<0.05), and the improvement rate of patients in obser-vation group was much higher than that in control group (P< 0.05). The serum NSE and hs-CRP of patients in two groups [(18.76±4.68) μg/L, (28.56±6.71) μg/L, (11.68±3.67) mg/L, (17.58±4.11) mg/L] obviously declined than before [(35.89±7.52) μg/L, (35.94±8.01) μg/L, (25.64±5.34) mg/L, (25.19±5.62) mg/L] (P < 0.05 or P < 0.01), <br> and the declining rate of patients in observation group was higher than that in control group (P<0.05). After comparing the occurrence rates of DAR of patients in two groups, no statistical differences appeared (χ2=0.18, P>0.05). Conclu-sion The application of NGF on patients with severe traumatic brain injury can effectively improve treatment effect, and has favorable protection effect on brain, whose mechanism of action has close effect on reducing serum NSE and hs-CRP levels.