鼠神經(jīng)生長因子對急性腦梗死患者血清超敏—C反應(yīng)蛋白和神經(jīng)元特異性烯醇化酶水平的影響及療效觀察

危英+李海軍

[摘要] 目的 探討鼠神經(jīng)生長因子對急性腦梗死患者血清超敏-C反應(yīng)蛋白（hs-CRP）和神經(jīng)元特異性烯醇化酶（NSE）水平的影響及療效觀察。方法 72例急性腦梗死患者隨機(jī)分為觀察組和對照組。兩組均予以控制顱內(nèi)壓、血壓和血糖、抗血小板聚集、保護(hù)腦細(xì)胞及防治并發(fā)癥等治療。觀察組患者加用鼠神經(jīng)生長因子18 μg肌肉注射，1次/d，連用2周。結(jié)果 治療2周后，兩組患者血清hs-CRP和NSE水平均有明顯下降（P<0.05或P<0.01），且觀察組下降值較對照組更明顯（P<0.05）；同時(shí)兩組患者NIHSS評分均明顯下降（P<0.05或P<0.01），F(xiàn)MA評分均明顯上升（P<0.05或P<0.01），且觀察組下降或上升值較對照組更明顯（P<0.05）。對照組和觀察組治療中出現(xiàn)不良反應(yīng)3例（8.33%）和6例（16.67%），癥狀均較輕。兩組治療中不良反應(yīng)發(fā)生率比較無統(tǒng)計(jì)學(xué)差異（χ2=0.51，P>0.05）。 結(jié)論 鼠神經(jīng)生長因子治療急性腦梗死具有較好的療效及安全性，能明顯改善患者的神經(jīng)功能及肢體運(yùn)動(dòng)功能，作用與其能降低血清Nhs-CRP和NSE水平密切相關(guān)。

[關(guān)鍵詞] 急性腦梗死；鼠神經(jīng)生長因子；超敏-C反應(yīng)蛋白；神經(jīng)元特異性烯醇化酶

[中圖分類號(hào)] R743 [文獻(xiàn)標(biāo)識(shí)碼] B [文章編號(hào)] 1673-9701（2014）02-0030-03

The influence and curative effect of mouse nerve growth factor on high-sensitivity C-reactive protein（hs-CRP） and neuron-specific enolase （NSE） in blood serum of acute cerebral infarction patients

WEI Ying LI Haijun

No.2 Department of Nerve， Taizhou Municipal Hospital， Zhejiang （The Affiliated Municipal Hospital of Taizhou Medical College）， Taizhou 318000，China

[Abstract] Objective To discuss the influence and curative effect of mouse nerve growth factor on high-sensitivity C-reactive protein（hs-CRP） and neuron-specific enolase （NSE） in blood serum of acute cerebral infarction patients. Methods 72 cases of acute cerebral infarction patients were divided into observation group and control group. All patients were given symptomatic and supportive treatment routinely like，intracranial pressure control， blood pressure and blood sugar control， platelet aggregation， brain cells protection， prevention and treatment of complications，and etc. The patients in observation group were given mouse nerve growth factor（18 μg） by intramuscular injection one time daily for 2 weeks. Results After 2 weeks medical treatment，the serum hs-CRP and NSE levels of patients in two groups obviously were declined than before （P<0.05 or P<0.01），and the declining rate of observation group was much higher than that in control group （P<0.05）. Meanwhile，NHSS scores of patients in two groups were declined obviously than before（P<0.05 or P<0.01），while the FMA scores were rose obviously than before（P<0.05 or P<0.01），and declining/rising rate of observation group was much higher than that the control group（P<0.05）. 3 cases（8.33%） and 6 cases（16.67%） cases of untoward effect appeared in control group and observation group with light DAR during the medical treatment. After comparing the untoward effect occurrence rates during the medical treatment， on obvious statistical differences appear（χ2=0.51，P>0.05）. Conclusion Mouse nerve growth factor has good clinical curative effect on acute cerebral infarction with security，and can obviously improve the function of nerve and body movement of patients，whose mechanism of action has close effect on reducing the serum hs-CRP and NSE levels.endprint

[Key words] Acute cerebral infarction； Mouse nerve growth factor； High sensitivity C-reactive protein； Neuron-specific enolase（NSE）

急性腦梗死是神經(jīng)科的常見疾病，治療后往往遺留后遺癥[1]。對急性腦梗死采取積極有效早期治療，促進(jìn)神經(jīng)功能的恢復(fù)，減少神經(jīng)系統(tǒng)后遺癥[2，3]。鼠神經(jīng)生長因子具有營養(yǎng)神經(jīng)元和促進(jìn)突起生長的作用，在急性腦梗死治療中的作用正逐漸受到臨床的重視[4]。近年來動(dòng)物研究發(fā)現(xiàn)鼠神經(jīng)生長因子可減輕腦梗死大鼠的神經(jīng)損傷，其作用與降低神經(jīng)元特異性烯醇化酶（NSE）水平有關(guān)，但有關(guān)其對患者血清NSE水平的影響國內(nèi)外報(bào)道不多[5-6]。本研究觀察了鼠神經(jīng)生長因子治療急性腦梗死前后患者血清hs-CRP和NSE水平的變化及療效，現(xiàn)報(bào)道如下。

1 資料與方法

1.1 一般資料

選擇2012年1月～2013年3月在我院神經(jīng)內(nèi)科住院治療的急性腦梗死患者72例。……