重组人促红细胞生成素治疗急性脑梗死疗效观察

Effect of recombinant human erythropoietin in the treatment of acute cerebral infarction

目的探讨重组人促红细胞生成素(rhEPO)治疗急性脑梗死(ACI)的临床效果及其对神经元特异性烯醇化酶(NSE)及炎性因子的影响。方法选择2013年9月至2016年6月新乡医学院第一附属医院收治的ACI患者98例,按照治疗方法分为观察组和对照组,每组49例。对照组患者给予常规治疗措施,观察组患者在常规治疗的基础上给予rhEPO,2组患者均治疗2周。分别于治疗前后检测2组患者血清血管内皮生长因子(VEGF)、肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)、NSE水平、红细胞比容(Hct)及血红蛋白(HGB)水平,应用美国国立卫生研究院卒中量表(NIHSS)进行神经功能缺损评分,并评定疗效。结果治疗前2组患者血清VEGF、TNF-α、IL-10、NSE水平比较差异均无统计学意义(P>0.05);2组患者治疗后血清VEGF水平显著高于治疗前(P<0.05),TNF-α、IL-10、NSE水平显著低于治疗前(P<0.05);治疗后观察组患者血清VEGF水平显著高于对照组(P<0.05),TNF-α、IL-10、NSE水平显著低于对照组(P<0.05)。治疗前2组患者NIHSS评分比较差异无统计学意义(P>0.05),2组患者治疗后NIHSS评分显著低于治疗前(P<0.05),治疗后观察组患者NIHSS评分显著低于对照组(P<0.05)。治疗前2组患者Hct、HGB水平比较差异均无统计学意义(P>0.05),2组患者治疗后Hct、HGB水平显著高于治疗前(P<0.05),治疗后观察组患者Hct、HGB水平显著高于对照组(P<0.05)。对照组和观察组患者治疗总有效率分别为61.22%(30/49)、81.63%(40/49),观察组患者治疗总有效率显著高于对照组(χ~2=7.381,P<0.05)。结论 rhEPO可以显著减轻ACI患者的炎症反应,改善患者的临床症状、神经功能及生活质量。

Objective To investigate the clinical effect of recombinant human erythropoietin （rhEPO） in the treatment of acute cerebral infarction （ACI） and its effect on neuron specific enolase （NSE） and inflammatory factors. Methods A total of 98 patients with ACI were selected from September 2013 to June 2016 in the First Affiliated Hospital of Xinxiang Medical University. The patients were divided into observation group and control group according to the treatment methods, with 49 cases in each group. The patients in the control group were treated with conventional treatment measures, and the patients in the observation group were treated with rhEPO on the basis of routine treatment, the patients in the two groups were treated for two weeks. The levels of serum vascular endothelial growth factor （VEGF）, tumor necrosis factor-or （TNF-α）, interleukin-10 （IL- 10 ）, NSE, hematocrit （Hct） and hemoglobin （HGB） were detected before and after treatment in the two groups. The neurolog- ic impairment was evaluated by the National Institutes of Health Stroke Scale （NIHSS） ,and the curative effect evaluated. Re- suits There was no significant difference in the level of serum VEGF ,TNF-α, IL-10 and NSE between the two groups before treatment（ P 〉0.05 ）. The serum VEGF level after treatment was significantly higher than that before treatment （P 〈 0.05 ）, and the levels of serum TNF-α,IL-10 and NSE after treatment were significantly lower than those before treatment in the two groups （P 〈 0. 05 ）. The serum VEGF level in the observation group was significantly higher than that in the control group （ P 〈 0.05）, and the levels of serum TNF-α, IL-10 and NSE in the observation group were significantly lower than those in the control group after treatment （ P 〈 0. 05 ）. There was no significant difference in NIHSS score between the two groups before treatment （P 〉 0.05 ）. The NIHSS score after treatment was significantly lower than that before treatment in the two groups （ P 〈 0.05 ）. The NIHSS score in the observation group was significantly lower than that in the control group after treatment （P 〈 0.05）. There was no significant difference in the levels of Hct and HGB between the two groups before treatment （ P 〉 0.05 ）. The levels of Hct and HGB after treatment were significantly higher than those before treatment in the two groups （ P 〈 0. 05 ）. The levels of Hct and HGB in the observation group were significantly higher than those in the control group after treat- ment （ P 〈 0.05 ）. The total effective rate in the control group and observation group was 61.22% （ 30/49 ） and 81.63 % （40/ 49） respectively, the total effective rate in the observation group was significantly higher than that in the control group （χ2 = 7. 381 ,P 〈 0. 05 ）. Conclusion rhEPO can significantly reduce the inflammatory response, and improve the clinical symp- toms, neurological function and quality of life in patients with ACI.