促红细胞生成素联合甲强龙治疗脊髓缺血再灌注损伤效果分析

Effects Analysis of Erythropoietin Combined with Methylprednisolone in the Treatment of Spinal Cord Ischemia-reperfusion Injury

目的探讨促红细胞生成素联合甲强龙治疗脊髓缺血再灌注损伤的效果。方法2011年8月-2015年7月选择在笔者医院进行诊治的脊髓型颈椎病患者56例，根据数字表法随机分为观察组与对照组各28例，两组手术方式都为减压植骨融合内固定术，对照组在脊髓减压前30rain开始快速静脉滴注甲强龙30mg／kg，在此基础上观察组同时滴注促红细胞生成素3000U／kg，两组都治疗观察14天。结果观察组与对照组术后3个月的JOA评分分别为15．09±2．14和12．48±2．98分，均明显高于术前的9．02±1．89和9．07±1．67分（P〈0．05），同时观察组术后3个月的JOA评分明显高于对照组（P〈0．05）。两组术后3个月的血清S-100B和NSE浓度均明显低于术前（P〈0．05），同时观察组术后3个月的血清S-100B和NSE浓度也均明显比对照组低（P〈0．05）。两组患者手术之前诱发电位波形种类比较，差异无统计学意义（P〉0．05），术后3个月均逐渐好转（P〈0．05），同时观察组术后3个月的诱发电位波形类型明显好于对照组（P〈0．05）。结论促红细胞生成素联合甲强龙治疗脊髓缺血再灌注损伤能有效改善脊髓型颈椎病患者的神经电生理状态，降低血清中S一100B和NSE的含量，从而发挥神经保护作用，有很好的应用价值。

Objective To investigate the effects of erythropoietin combined with methylprednisolone in the treatment of spinal cord ischemia - reperfusion injury. Methods From August 2011 to July 2015 in our hospital, 6 paitents of cervical myelopathy for diagnosis and treatment were selected in our hospital and were accorded to randomly were equally divided into observation group and control group of 28 patients, two groups were given the surgical decompression arc fusion and internal fixation, and the control group were given the rapid intravenous infusion of methylprednisolone 30mg/kg before spinal decompression 30min, on the basis of the observation group while were given the infusion of erythropoietin 3000U/kg, the prognosisi were observed 14d. Results The postoperative 3 months of JOA scores in the observation group and control group were 15.09 ＋ 2. 14 and 12.48 ：t： 2.98 points that were significantly higher than preoperative of 9.02 ＋ 1.89 and 9.07 ＋ 1.67 points （P 〈 0.05 ） , while the postoperative 3 months of JOA scores in the observation group were signifi- cantly higher （P 〈 0.05）. The postoperative 3 months of serum S - IOOB and NSE levels in the two groups were significantly lower than the preoperative （ P 〈 0.05 ） , while the postoperative serum S - 100B and NSE levels in the observation group were also significantly lower than the control group （P 〈 0.05）. The postoperative evoked potential waveform types compared between the two groups were not statisti- cally significant, and the postoperative 3months were gradually improved （P 〈 0.05 ） , while the postoperative 3months evoked potential waveform types in the observation group were significantly better than the control group （P 〈 0.05）. Conclusion Erythropoietin com- bined with methylprednisolone in the treatment of spinal cord ischemia - reperfusion injury can improve the neurophysiologieal state of pa- tients with cervical myelopathy, reduce the levels of serum S- 100B and NSE, which play a neuroprotective effect that has good values.