[1]平明亮,宋 朝.鼠神经生长因子联合康复训练治疗急性脊髓损伤疗效观察[J].新乡医学院学报,2019,36(9):847-850.[doi:10.7683/xxyxyxb.2019.09.010]
 PING Ming-liang,SONG Chao.Effect of mouse nerve growth factor combined with rehabilitation training in treatment of acute spinal cord injury[J].Journal of Xinxiang Medical University,2019,36(9):847-850.[doi:10.7683/xxyxyxb.2019.09.010]
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鼠神经生长因子联合康复训练治疗急性脊髓损伤疗效观察
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
36
期数:
2019年9
页码:
847-850
栏目:
临床研究
出版日期:
2019-09-05

文章信息/Info

Title:
Effect of mouse nerve growth factor combined with rehabilitation training in treatment of acute spinal cord injury
作者:
平明亮1宋 朝2
(1.郑州市第十人民医院康复医学科,河南 郑州 450000;2.郑州市中心医院康复医学部,河南 郑州 450000)
Author(s):
PING Ming-liang1SONG Chao2
(1.Department of Rehabilitation Medicine,the Tenth People′s Hospital of Zhengzhou City,Zhengzhou 450000,Henan Province,China;2.Department of Rehabilitation Medicine,Zhengzhou Central Hospital,Zhengzhou 450000,Henan Province,China)
关键词:
急性脊髓损伤鼠神经生长因子康复训练神经功能
Keywords:
acute spinal cord injurymouse nerve growth factorrehabilitation trainingneurological function
分类号:
R651.2
DOI:
10.7683/xxyxyxb.2019.09.010
文献标志码:
A
摘要:
目的 探讨鼠神经生长因子(mNGF)联合康复训练治疗急性脊髓损伤(ASCI)患者的临床效果。方法 选择2013年2月至2016年12月于郑州市第十人民医院进行手术治疗的ASCI患者56例,根据术后治疗方法将患者分为观察组和对照组,每组28例。2组患者均给予常规对症支持治疗,对照组患者在对症支持治疗的基础上进行康复训练,康复训练于术后15 d开始;在对照组患者治疗基础上,观察组患者给予注射用mNGF 20 μg,肌肉注射,每日1次;2组患者均30 d为1个疗程,治疗2个疗程。分别于治疗前及治疗后1 d、1 a采用美国脊椎损伤协会(ASIA)评分标准评估2组患者的神经功能,并进行脊髓损伤Frankel分级,采用Barthel指数评估2组患者的日常生活能力。结果 治疗前2组患者感觉功能及运动功能评分比较差异均无统计学意义(P>0.05),2组患者治疗后1 d、1 a时感觉功能及运动功能评分显著高于治疗前(P<0.05),治疗后1 a时感觉功能及运动功能评分显著高于治疗后1 d(P<0.05);治疗后1 d、1 a,观察组患者感觉功能及运动功能评分显著高于对照组(P<0.05)。治疗后1 d、1 a,观察组患者脊髓损伤改善率分别为46.2%(13/28)、85.7%(24/28),对照组患者脊髓损伤改善率分别为28.6%(8/28)、64.2%(18/28);2组患者治疗后1 a脊髓损伤改善率显著高于治疗后1 d(χ2=9.172、10.748,P<0.05);治疗后1 d、1 a,观察组患者脊髓损伤改善率显著高于对照组(χ2=6.461、7.015,P<0.05)。2组患者治疗前生活能力评分比较差异无统计学意义(P>0.05);2组患者治疗后1 d、1 a时生活能力评分显著高于治疗前(P<0.05),治疗后1 a时生活能力评分显著高于治疗后1 d(P<0.05);治疗后1 d、1 a,观察组患者生活能力评分显著高于对照组(P<0.05)。结论 mNGF联合康复训练可有效促进ASCI患者神经功能恢复,提高患者生活质量。
Abstract:
Objective To investigate the clinical effect of rat nerve growth factor (mNGF) combined with rehabilitation training in treatment of acute spinal cord injury (ASCI).Methods Fifty-six patients with ASCI who underwent surgical treatment in the Tenth People′s Hospital of Zhengzhou City from February 2013 to December 2016 were selected and divided into observation group and control group according to the post-operative treatment methods,with twenty-eight cases in each group.The patients in the two groups were given routine symptomatic support treatment,while the patients in the control group began rehabilitation training at 15 days after operation on the basis of symptomatic support treatment.On the basis of the treatment in the control group,the patients in the observation group were treated with mNGF 20 μg,intramuscular injection once a day.The patients in the two groups were treated for two courses of treatment (30 days as a course of treatment).Neurological function of the patients was evaluated by the scoring standard of American Spinal Injury Association,and the Frankel classification of spinal cord injury was performed,and the activity of daily living (ADL) of patients in the two groups was assessed by Barthel index.Results There was no significant difference in sensory and motor function scores between the two groups before treatment (P>0.05).The scores of sensory and motor function at one day and one year after treatment were significantly higher than those before treatment (P<0.05),and the scores of sensory and motor function at one year after treatment were significantly higher than those at one day after treatment in two groups (P<0.05).The scores of sensory and motor function in the observation group were significantly higher than those in the control group at one day and one year after treatment (P<0.05).The improvement rate of spinal cord injury in the observation group was 46.2% (13/28) and 85.7% (24/28) respectively,and that in the control group was 28.6% (8/28) and 64.2% (18/28) respectively at one day and one year after treatment.The improvement rate of spinal cord injury at one year after treatment was significantly higher than that at one day after treatment in the two groups (χ2=9.172,10.748;P<0.05).The improvement rate of spinal cord injury in the observation group was significantly higher than that in the control group at one day and one year after treatment (χ2=6.461,7.015;P<0.05).There was no significant difference in the score of ADL between the two groups before treatment (P>0.05).The scores of ADL at one day and one year after treatment were significantly higher than those before treatment (P<0.05),and the scores at one year after treatment were significantly higher than those at one day after treatment in the two groups (P<0.05).The scores of ADL in the observation group were significantly higher than those in the control group at one day and one year after treatment (P<0.05).Conclusion mNGF combined with rehabilitation training can effectively promote the recovery of neurological function and improve the quality of life in patients with ASCI.

参考文献/References:

[1] SINDELAR B,BAILES J E.Neurosurgical emergencies in sport[J].Neurol Clin,2017,35(3):451-472.
[2] 李宇博,丁立祥.脊髓损伤的近期研究进展[J].中国矫形外科杂志,2014,22(22):2075-2078.
[3] 刘江,李先强.脊髓损伤的外科治疗进展[J].山东医药,2010,50(15):114-115.
[4] 王淑芳,张莉,张雯雯,等.鼠神经生长因子在突发性耳聋中的疗效观察[J].中华耳科学杂志,2016,14(2):223-228.
[5] 官常荣,朱英标,丁莉,等.鼠神经生长因子联合α-硫辛酸治疗糖尿病周围神经病变的临床观察[J].中国临床药理学杂志,2014,30(10):892-894,900.
[6] 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.
[7] 吴猛,李雄锋,吴玮,等.神经节苷脂联合康复训练对脊髓损伤患者炎性因子及神经功能恢复的影响[J].中国临床药理学杂志,2016,32(12):1081-1084.
[8] 王方永,李建军.脊髓损伤神经学分类国际标准(ASIA 2011版)最新修订及标准解读[J].中国康复理论与实践,2012,18(8):797-800.
[9] 王艳,易祖玲,杨雍,等.医护一体化模式在后路腰椎减压内固定围手术期护理的应用[J].颈腰痛杂志,2014,35(6):459-461.
[10] KONG X,GAO J.Macrophage polarization:a key event in the secondary phase of acute spinal cord injury[J].J Cell Mol Med,2017,21(5):941-954.
[11] 王涛,吴成如,王海峰,等.褪黑激素对海水浸泡兔脊髓损伤的保护作用[J].解放军医学杂志,2017,42(2):134-139.
[12] PLOTKIN J L,WU C.Neurotrophin biology at NGF 2016:from fundamental science to clinical applications[J].Int J Dev Neurosci,2017,56(1):27-34.
[13] 马华.神经碎片联合NGF在自体神经外膜小间隙修复周围神经损伤[J].航空航天医学杂志,2017,28(4):389-391.
[14] 李铮,梁汇珉,李赵伟,等.神经生长因子在糖尿病大鼠视网膜突触可塑性中的作用[J].眼科新进展,2017,37(9):816-818,823.
[15] 徐如祥.神经生长因子的神经损伤修复机制及作用[J].中华神经创伤外科电子杂志,2016,2(1):1-4.DOI:10.3877/cma.j.issn.2095-9141.2016.01.001.
[16] 唐家发.针灸结合康复治疗干预时机对不同程度脊髓损伤患者神经功能恢复的影响[J].中国医药指南,2013,11(9):289-290.

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更新日期/Last Update: 2019-09-05