鼠神经生长因子治疗小儿急性中毒性脑病疗效及对心肌酶与炎性因子的影响

The Eeffect of Rat Nerve Growth Factor on the Treatment of Acute Toxic Encephalopathy in Children and Its Effect on Myocardial Enzymes and Inflammatory Factors

目的探讨鼠神经生长因子治疗小儿急性中毒性脑病的疗效及对心肌酶与炎性因子的影响。方法急性中毒性脑病患儿88例,随机分为对照组30例,治疗组58例。对照组给予相应的病因及对症治疗。治疗组在此基础上,加用鼠神经生长因子15天为一疗程。治疗1个月、2个月、3个月比较两组患儿神经症状、运动功能障碍等改善及头颅MRI改变情况。入院后第1天和治疗90天后抽空腹静脉血检测CK、CKMB、AST、LDH、HBD、IL-1、IL-6、IL-8、IL-10、TNF-α水平变化。应用SPSS20.0软件,所获数据采用方差分析、t检验和2检验。结果治疗组58例,神经症状改善52例,占89.65%;运动功能改善44例,占75.86%;头颅MRI改善48例,占82.7%,总有效率为89.65%。对照组30例,神经症状改善9例,占30.00%;运动功能改善15例,占50.00%;头颅MRI改善10例,占33.33%,总有效率为66.67%。两组比较,P<0.01。所有病例未发现有明显过敏反应。对照组治疗前后CK水平变化比较,P<0.05;治疗前后CKMB、AST、LDH、HBD水平变化比较,P均<0.0005。治疗组治疗前后CK、CKMB、AST、LDH、HBD水平变化比较,P均<0.0005;两组治疗后CK、CKMB、AST、LDH、HBD水平变化比较,P均<0.0005。对照组治疗前后血清IL-1、IL-8、TNF-α水平变化比较,P均<0.0005;对照组治疗前后血清IL-6、IL-10水平变化比较,P均<0.005。治疗组治疗前后血清IL-1、IL-6、IL-8、IL-10、TNF-α水平变化比较,P均<0.0005。两组治疗后血清IL-1、IL-8、IL-10、TNF-α水平变化比较,P均<0.0005;两组治疗后血清IL-6水平变化比较,P<0.001。结论鼠神经生长因子能够明显改善急性中毒性脑病患儿的神经、运动功能,具有显著的治疗效果,随着病情的好转心肌酶及炎性因子也逐渐恢复正常。

Objective To investigate the effect of rat nerve growth factor on the treatment of acute toxic encephalopathy in children and its effect on myocardial enzymes and inflammatory factors. Methods 88 cases of acute toxic en- cephalopathy were randomly divided into control group. The treatment group was 58 cases. The control group was given corresponding treatment for the cause and symptomatic treatment. On this basis, the treatment group was treated with 15 days of rat nerve growth factor. In January, February and march, the improvement of neurological symptoms, motor dys- function, and other improvement of the head MRI were compared in the two groups. After the first day of admission and the treatment of the patients after 90 days, the patients with ventral venous blood were found to have the horizontal chang- es of CK, CKMB, AST, LDH, HBD, il-1, il-6, il-8, il-10, and TNF - alpha. Using SPSS20.0 software, the data obtained were variance analysis, t test and Z2 test. Results 58 cases of neurological symptoms in the treatment group were im proved by 52 cases, accounting for 89.65 %. Motor function improved 44 cases, accounting for 75.86%. Skull MRI improved 48 cases, accounting for 82.7%. The total effective rate of treatment was 89.65 %. In the control group, there were 30 cases and 9 cases of neurological improvement, accounting for 30.00%. Motor function improved 15 cases, accounting for 50.00%. Skull MRI was improved in 10 cases, 33.33%. Total effective rate of control group was 66.67%. Comparison of the two groups, P〈0.01. No significant allergic reactions were found in all cases. Comparison of CK level changes before and after treatment in the control group,P〈0.05. Compared with the changes of CKMB, AST, LDH and HBD in the control group, P was 〈0.0005. The changes of CK, CKMB, AST, LDH and HBD were compared before and after treatment group, P was 〈0.0005. After treatment, the changes of CK, CKMB, AST, LDH and HBD were compared with P〈 0.0005. Comparison of serum il-1, il-8 and TNF - alpha in the control group was compared with P〈0.0005. Comparison of serum il-6 and il-10 levels in the control group was compared with P〈0.005. The serum il-1, il-6, il-8, il-10 and TNF - alpha were compared in the treatment group before and after treatment, with P 〈 0.0005. The serum il-1, il-8, il- 10 and TNF - alpha were compared in the two groups after treatment, with P〈0.0005. Comparison of serum il-6 levels after treatment was compared with P〈0.001. Conclusion the rat nerve growth factor can significantly improve the nerve and motor function of children with acute toxic encephalopathy, and have remarkable therapeutic effect. The myocardial enzyme and inflammatory factor gradually returned to normal as the disease improved.