注射用鼠神经生长因子对重型颅脑损伤合并肺部感染患者血清相关炎症因子的影响研究

Effect of mouse nerve growth factor for injection on serum related inflammatory factors in patients with severe brain injury complicated with pulmonary infection

目的探讨注射用鼠神经生长因子(NGF)对重型颅脑损伤合并肺部感染患者血清高迁移率族蛋白-1(HMGB-1)和内源性分泌型晚期糖基化终产物受体(es RAGE)水平的影响,以及治疗前后血清促炎细胞因子白细胞介素1β(IL-1β),肿瘤坏死因子-α(TNF-α)的变化及相互关系。方法选取达州市中西医结合医院2013年1月至2015年6月住院神经外科及ICU重型颅脑损伤合并肺部感染患者78例,随机数字法分组,对照组39例采取常规对症治疗,研究组39例均在常规治疗基础上采用注射用鼠NGF治疗。酶联免疫法(ELISA)测定血清HMGB1、esRAGE、IL-1β及TNF-α水平并在入院时、入院1w、2w时记录格拉斯哥昏迷评分(GCS)状况。结果治疗2w后,研究组确诊1w、确诊2w时HMGB1和es RAGE水平低于对照组,差异有统计学意义(P<0.05);相比对照组,研究组确诊2w GCS评分明显低于低于对照组(P<0.01);研究组患者治疗前血清HMGB-1及esRAGE水平分别与IL-1β,TNF-α水平,GCS评分呈正相关(r1=0.238、r1=0.473、r2=0.429、r2=0.518,r3=0.319、r3=0.421,均P<0.05)。结论注射用鼠NGF能降低重型颅脑损伤合并肺部感染患者血清HMGB1及es RAGE水平,有明显治疗效果。且HMGB1及es RAGE可能在重型颅脑损伤合并肺部感染进程中发挥促炎作用,与IL-1β及TNF-α共同介导该类疾病的发生发展。

Objective To investigate the mouse nerve growth factor （ NGF ） for injection high mobility group protein-1 （ HMGB-1 ） in serum of patients with pulmonary infection in severe craniocerebral injury of endogenous secretory receptor for advanced glycation end products （ esRAGE ） levels, and serum proinflammatory cytokine interleukin 1 beta （ IL-1 beta ） , tumor necrosis factor alpha （ TNF- alpha ） and the changes of the relationship. Methods Chinese and Western Medicine Hospital of Dazhou from January 2013 to June 2015 in the department of neurosurgery, and ICU diagnosed seventy-eight cases with severe craniocerebral injury complicated with pulmonary infection were randomly grouped, thirty-nine cases in the control group took routine symptomatic treatment, the study group of thirty-nine cases diagnosed by mouse nerve growth factor （ NGF ） for injection ＇after treatment on the basis of routine treatment for 2 weeks. Enzyme linked immunosorhent assay （ ELISA ） was determined in the serum HMGB-1, esRAGE, IL-1 and TNF- levels and GlasgowComa Score （ GCS ） were recorded at 1 weeks and 2 weeks after diagnosis. Results after 2 weeks of treatment, the study group were diagnosed in 1 weeks and 2 weeks, the serum HMGB-1 of endogenous secretory receptor for advanced glycation end products （ esRAGE ） level is lower than the control group, the difference was statistically significant （ P〈0.05 ） ; compared with the control group, the study group diagnosed two weeks GCS the score was significantly lower than than in the control group （ P〈0.01 ） ; the study group of patients before treatment the serum HMGB-1 and esRAGE levels respectively and proinflammatory cytokine interleukin 1 beta （ IL-1 beta ）, TNF-alpha levels, GCS were positively related （ r1= 0.238, r1= 0.473, r2= 0.429,r2=0.518. r3= 0.319, r3=OA21, P〈0.05 ） . Conclusion Mouse NGF for injection can reduce the damage of serum HMGB-1 and esRAGE levels in patients with pulmonary infection in severe craniocerebral, has obvious curative effect. And HMGB- 1 and esRAGE in severe craniocerebral injury complicated with pulmonary infection in the process of playing the proinflammatory effects, development of IL-1 and TNF- alpha beta mediated by the disease.