单唾液酸四己糖神经节苷脂对急性脑出血患者血清基质金属蛋白酶-2和9水平的影响及疗效观察

Influence and curative observation of Monosialotetrahexosyl Ganglioside on serum matrix metalloproteinase-2 and 9 of acute cerebral hemorrhage patients

目的探讨单唾液酸四己糖神经节苷脂对急性脑出血患者血清基质金属蛋白酶(MMP)-2和9水平的影响及疗效观察。方法将68例急性脑出血患者随机分为观察组和对照组。两组患者均酌情予以控制颅内压、血压和血糖、营养脑细胞、止血等对症支持治疗。观察组患者加用单唾液酸四己糖神经节苷脂针60 mg加入5%葡萄糖或生理盐水250 mL中静滴,每日1次,连用2周。对照组患者除不使用单唾液酸四己糖神经节苷脂针外余同观察组。观察两组患者治疗前后血清MMP-2和9水平的变化,并进行临床疗效观察。结果治疗2周后,对照组和观察组患者血清MMP-2和9水平[(73.45±20.42)、(133.47±34.27)、(54.72±19.13)、(94.72±27.15)μg/L]均较治疗前[(90.73±24.82)、(181.73±45.16)、(91.52±27.57)、(184.03±47.02)μg/L]明显下降(t=2.32、2.45、2.87、3.21,P<0.05或P<0.01),且观察组患者下降的幅度较对照组更明显(t=2.21、2.45,P<0.05);同时治疗2周后,观察组患者临床总有效率(94.12%)明显高于对照组(70.59%)(χ2=6.48,P<0.05)。结论单唾液酸四己糖神经节苷脂治疗急性脑出血疗效确切,作用与其能降低血清MMP-2和9水平,抑制细胞外基质降解,从而减少脑出血引起的炎症反应及继发性脑损伤,促进神经功能恢复密切相关。

Objective To discuss the influence and curative observation of Monosialotetrahexosyl Ganglioside on serum matrix metalloproteinase-2 and 9 （MMP-2 and 9） of acute cerebral hemorrhage patients. Methods 68 cases of acute cerebral hemorrhage patients were divided into observation group and control group at random. The patients in two groups were given symptomatic and supportive treatment like control of intracranial pressure, blood pressure and blood sugar, brain cells nutrition, hemostasis and etc. In addition, the patients in observation group were given the injection of Monosialotetrahexosyl Ganglioside （60 rag） into glucose （5%） or physiological saline （250 mL） by dripping one time daily for 2 weeks. Except for the injection of Monosialotetrahexosyl Ganglioside, the patients in control group were giv- en the same medical treatment as that in observation group. The changes of serum MMP-2 and 9 levels before and after medical treatment were observed, and the clinical curative observation was carried on. Results After 2 weeks＂ med- ical treatment, the serum MMP-2 and 9 levels of patients in control group and observation group [（73.45±20.42）, （133.47±34.27）, （54.72±19.13）, （94.72±27.15） μg/L] declined obviously than before [（90.73±24.82）, （181.73±45.16）, （91.52±27.57）, （184.03±47.02） μg/L] （t = 2.32, 2.45, 2.87, 3.21, P 〈 0.05 or P 〈 0.01）, and the declining rate in ob- servation group was much higher than that in control group （t = 2.21, 2.45, P 〈 0.05）. Meanwhile, after 2 weeks＂ medi- cal treatment, the total clinical efficiency of patients in observation group （94.12%） was much higher than that in con- trol group （70.59%） （x2=6.48, P 〈 0.05）. Conclusion Monosialotetrahexosyl Ganglioside has reliable curative effect on acute cerebral hemorrhage, whose mechanism of action has close effect on lowering serum MMP-2 and 9 levels and in- hibiting the degradation of extracellular matrix, and then reduces the inflammatory reaction caused by cerebral hemor- rhage and secondary brain injury, and promotes the recovery of nerve function.