注射用鼠神经生长因子联合甲泼尼龙治疗急性脊髓损伤的临床效果观察

Clinical observation of methylprednisolone combined with mouse nerve growth factor for injection on treating acute spinal cord injury

目的研究注射用鼠神经生长因子联合甲泼尼龙治疗急性脊髓损伤的临床效果。方法选择2013年5月—2017年5月在铜川市人民医院进行诊治的急性脊髓损伤患者60例,随机分为两组。两组均采取内固定术、椎管减压术、止血、抗炎以及脱水等常规治疗。对照组静脉滴注甲泼尼龙30 mg/kg,持续15 min后,再按照每小时5.4 mg/kg的剂量进行连续静脉滴注23 h,观察组联合肌内注射鼠神经生长因子进行治疗,每次30μg,每天1次,两组均治疗2个月。比较两组的临床治疗效果,治疗前后的运动功能和感觉功能评分,独立性生活能力和日常生活能力评分,以及不良反应发生情况。结果观察组的有效率为80.00%(24/30),明显高于对照组的63.33%(19/30),差异有统计学意义(P<0.05)。两组治疗后的运动功能以及感觉功能评分均明显升高,同组治疗前后比较差异有统计学意义(P<0.05);且观察组明显高于对照组,差异有统计学意义(P<0.05)。两组治疗后的独立性生活能力以及日常生活能力评分均明显升高,同组治疗前后比较差异有统计学意义(P<0.05);且观察组明显高于对照组,差异有统计学意义(P<0.05)。观察组的药物不良反应发生率为16.67%(5/30),与对照组的20.00%(6/30)相比无明显差异。结论注射用鼠神经生长因子联合甲泼尼龙治疗急性脊髓损伤的临床效果明显优于单独采用大剂量甲泼尼龙冲击治疗,可以有效改善患者的神经功能,提高生活能力,且安全性较高。

Objective To investigate clinical observation of methylprednisolone combined with mouse nerve growth factor for injection on treating acute spinal cord injury. Methods From May 2013 to May 2017, 60 patients with acute spinal cord injury in our hospital were selected and randomly divided into two groups. The two groups were all treated by conventional therapy including internal fixation, spinal canal decompression, hemostasis, anti-inflammation, dehydration and so on. The methylprednisolone was intravenous instilled into control group with 30 mg/kg for 15 min, and then it was intravenous in stilled continuously for 23 h according to dosage of 5.4 mg/kg per hour. The treatment both intravenous instillation of methylprednisolone and intramuscular injection of mouse nerve growth factor with 30 μg per time and 1 time per day were applied in the observation group. The two groups were all treated for two months. Clinical therapeutic efficacy was compared in the two groups. The indexes, such as motor and sensory function, independent living and daily living ability, occurrence of adverse reactions, were scored before and after the treatment. Results The effective rate in observation group 80.00%（24/30） was higher dramatically than that in control group 63.33%（19/30）（P〈0.05）. After treatment, the score of motor and sensory function, independent living and daily living ability both in two groups were all increased significantly（P〈0.05）, and the increase in observation group was more obvious than that in control group（P〈0.05）. The incidence of adverse reactions had no significant difference between that in observation group 16.67%（5/30）） and control group 20.00%（6/30）. Conclusion Clinical efficacy of methylprednisolone combined with mouse nerve growth factor for injection on treating acute spinal cord injury is obviously superior to use a massive dose of methylprednisolone pulse therapy alone. The treatment of methylprednisolone combined with mouse nerve growth factor for injection can improve effectively neurological function of patients and increase living ability, and having high security.