鼠神经生长因子对急性外展神经麻痹合并糖尿病的疗效研究

Curative Efficacy of Mouse Nerve Growth Factor on Acute Abducens Nerve Palsy Complicating Diabetes Mellitus

目的观察急性外展神经麻痹合并糖尿病在不能使用激素的前提下单独注射鼠神经生长因子(mNGF)的疗效。方法回顾性分析2009年1月至2013年6月医院眼科诊治的急性外展神经麻痹合并糖尿病患者61例(68眼)的临床资料,所有患者均以血糖控制在正常范围内为治疗前提,根据治疗方法不同分为观察组(20眼,不用药,以观察为主)、常规组(23眼,给血管扩张剂和B族维生素)、mNGF组(25眼,肌肉注射鼠神经生长因子)。根据患者治疗前后复视的变化,患侧外直肌外转不到位的距离,以及同视机在水平方向上斜视度的测定,判定药物疗效。结果治疗1个月后观察组和常规组少数患者自觉复视减轻,但斜视度与治疗前比较无明显差异(P>0.05);常规组患侧外直肌外转不到位较前好转(P<0.05);mNGF组较治疗前部分患者复视症状减轻或消失,斜视度较治疗前明显下降(P<0.05),患侧外直肌外转不到位较前好转(P<0.05)。结论鼠神经生长因子(在不能使用激素时)对治疗急性外展神经麻痹合并糖尿病患者疗效良好。

Objective To investigate the efficacy of mouse nerve growth factor on acute abducens nerve palsy complicating diabetes in the premise without using hormone.Methods The clinical data in 61 cases（68 eyes） of acute abducens nerve palsy complicating diabetes in the ophthalmological department of our hospital from January 2009 to June 2013 were analyzed retrospectively.In the therapeutical premise of blood glucose control in the normal range,all the patients were divided into the observation group（20 eyes,no medication,dominated by observation）,the routine group（23 eyes,given vasodilators and vitamin B） and the mNGF group （25 eyes,mouse nerve growth factor by intramuscular injection）.The medication efficacy was evaluated by the changes of diplopia,the distance of affected lateral external rectus muscle abversion not in place and the detection of the strabismus degree of synoptophore in the horizontal direction before and after treatment.Results The minority patients in the observation and the routine group felt diplopia relieved after 1-month treatment,but the strabismus degree had no difference compared with before treatment（P〉0.05）; the affected lateral external rectus muscle abversion not in place in the routine group was improved compared with before treatment（P〈0.05）; the diplopia symptom in the partial patients of the mNGF group was relieved or disappeared after treatment,the strabismus degree was significantly decreased compared with before treatment（P 〈 0.05）,and the affected lateral external rectus muscle abversion not in place was improved than that before treatment（P 〈 0.05）.Conclusion Mouse nerve growth factor without using hormone has a very good effect in treating acute abducens nerve palsy complicating diabetes.