强化神经营养方案对急性脑出血患者的影响研究

Impact of Intensive Nerve Nutrition Scheme on Acute Cerebral Hemorrhage

目的探讨强化神经营养方案对急性脑出血患者的影响。方法选取2013年2月—2016年2月延安大学咸阳医院收治的急性脑出血患者140例,按照随机数字表法分为对照组和观察组,每组70例。对照组患者在对症治疗基础上予以单唾液酸四己糖神经节苷脂钠治疗,观察组患者在对照组基础上予以注射用鼠神经生长因子治疗;两组患者均连续治疗4周。比较两组患者临床疗效及治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、水肿面积、血肿体积、Barthel指数(BI)评分、炎性因子〔基质金属蛋白酶9(MMP-9)、N末端B型脑钠肽前体(NT-pro BNP)、白介素8(IL-8)、肿瘤坏死因子α(TNF-α)〕水平、氧化应激指标〔丙二醛(MDA)、超氧化物歧化酶(SOD)〕和髓鞘碱性蛋白(MBP)水平。结果观察组患者临床疗效优于对照组(P<0.05)。治疗前两组患者NIHSS评分、水肿面积、血肿体积、BI评分比较,差异无统计学意义(P>0.05);治疗后观察组患者NIHSS评分低于对照组,水肿面积、血肿体积小于对照组,BI评分高于对照组(P<0.05)。治疗前两组患者MMP-9、NT-pro BNP、IL-8、TNF-α水平比较,差异无统计学意义(P>0.05);治疗后观察组患者MMP-9、NT-pro BNP、IL-8、TNF-α水平低于对照组(P<0.05)。治疗前两组患者MDA、SOD水平比较,差异无统计学意义(P>0.05);治疗后观察组患者MDA、SOD水平低于对照组(P<0.05)。治疗前两组患者MBP水平比较,差异无统计学意义(P>0.05);治疗后观察组患者MBP水平低于对照组(P<0.05)。结论强化神经营养方案可有效提高急性脑出血患者临床疗效,改善患者神经功能,促进脑血肿及水肿消退,提高患者日常生活能力,调节炎性因子、氧化应激状态及MBP水平。

Objective To investigate the impact of intensive nerve nutrition scheme on acute cerebral hemorrhage.Methods A total of 140 patients with acute cerebral hemorrhage were selected in Xianyang Hospital of Yan＇ an University from February 2013 to February 2016,and they were divided into control group and observation group according to random number table,each of 70 cases. Patients of control group received monosialotetrahexosyl ganglioside sodium based on symptomatic treatment,while patients of observation group received mouse nerve factor injection based on that of control group; both groups continuously treated for 4 weeks. Clinical effect,NIHSS score,edema area,hematoma volume,Barthel index,inflammatory cytokines（ including MMP-9,NT-pro BNP,IL-8 and TNF-α）,index of oxidative stress（ including MDA and SOD） and MBP before and after treatment were compared between the two groups. Results The clinical effect of observation group was statistically significantly better than that of control group（ P〈0. 05）. No statistically significant differences of NIHSS scroe,edema area,hematoma volume or Barthel index was found between the two groups before treatment（ P〉0. 05）; after treatment,NIHSS score of observation group was statistically significantly lower than that of control group,edema area and hematoma volume of observation group were statistically significantly smaller than those of control group,while Barthel index of observation group was statistically significantly higher than that of control group（ P〈0. 05）. No statistically significant differences of MMP-9,NT-pro BNP,IL-8 or TNF-α was found between the two groups before treatment（ P〉0. 05）,while MMP-9,NT-pro BNP,IL-8and TNF-α of observation group were statistically significantly lower than those of control group after treatment（ P〈0. 05）. No statistically significant differences of MDA or SOD was found between the two groups before treatment（ P〉0. 05）,while MDA and SOD of observation group were statistically significantly lower than those of control group after treatment（ P〈0. 05）. No statistically significant differences of MBP was found between the two groups before treatment（ P〉0. 05）, while MBPof observation group was statistically significantly lower than that of control group after treatment（ P〈0. 05）. Conclusion Intensive nerve nutrition scheme can effectively improve the clinical effect,neurological function and activity of daily living of patients with acute cerebral hemorrhage,promote the extinction of hematoma and edema, adjust the inflammatory cytokines,oxidative stress state and MBP level.