鼠神经生长因子、亚低温联合甲强龙在急性脊髓损伤中的应用及对氧化应激水平的影响

Application of nerve growth factor, methylprednisolone, and mild hypothermia in acute spinal cord injury and their effect on oxidative stress

摘要:

目的 探讨鼠神经生长因子、亚低温联合甲强龙治疗急性脊髓损伤的临床疗效及对氧化应激水平的影响。方法 选取2016年5月—2018年6月延安大学附属医院收治的急性脊髓损伤患者132例作为研究对象。按随机数字表法分为对照组和观察组，每组66例。对照组静脉滴注甲强龙，初始剂量为30 mg/kg，随后以5.4 mg/（kg·h）的速度持续静脉滴注23 h，同时给予亚低温治疗，降温同时给予静脉滴注冬眠合剂维持24 h；观察组在对照组的基础上，肌内注射鼠神经生长因子30 g/d，持续给药2个月。观察两组患者脊髓功能恢复情况，包括：ADL、运动、触觉及针刺觉检查评分；观察血清GSH-Px和SOD的变化，追踪两组患者的并发症。结果 两组患者治疗后ADL、运动、触觉及针刺觉检查评分较治疗前升高（P <0.05）；观察组的评分高于对照组（P <0.05）；两组患者治疗后血清GSH-Px和SOD水平较治疗前升高（P <0.05）；观察组的氧化应激水平高于对照组（P <0.05）；两组患者并发症发生率差异无统计学意义（P >0.05）。结论 在甲强龙背景治疗下，鼠神经生长因子联合亚低温能促进急性脊髓损伤患者的神经功能恢复，提高患者的生活质量。

Abstract:

Objective Application of nerve growth factor, methylprednisolone, and mild hypothermia in acute spinal cord injury and the effect on oxidative stress.Methods Totally 132 patients with acute spinal cord injury admitted to our hospital from May 2016 to June 2018 were included in the control group and the observation group according to the random number table, 66 cases in each group. The control group was intravenously injected with methylprednisolone sodium succinate for an initial dose of 30 mg/kg, followed by continuous intravenous infusion for 23 hours at a rate of 5.4 mg/kg per hour and mild hypothermia treatment, and the intravenous drip of hibernating mixture was given for 24 h. On the basis of the control group, the observation group received intramuscular injection of mouse nerve growth factor 30 μg/d, continuous administration for 2 months. Recovery indexes of spinal cord function in the two groups were compared, including: ADL score, exercise test score, tactile test score, and acupuncture test score. The changes of oxidative stress levels in serum GSH-Px and SOD levels were observed, as well as the complications in the clinical efficacy of the two groups.Results The ADL, exercise test, tactile test, and acupuncture test of the two groups were higher than those of before treatment, and the elevated level of the observation group was significantly higher than that of the control group (P < 0.05). The level of Oxidative stress markers (GSH-Px and SOD) of both groups were increased after treatment, and the elevated levels in the observation group were significantly higher than control group (P < 0.05). However, there was no significant difference in the incidence of complications between the two groups (P > 0.05).Conclusion Rat nerve growth factor, methylprednisolone combined with mild hypothermia can improve the recovery of nerve function and the quality of life of patients with acute spinal cord injury.