二联神经营养方案对高血压性脑出血患者疗效及实验室指标的影响

Influence of bigeminy nerve nutrition scheme on clinical effects and laboratory indexes of patients with hypertensive cerebral hemorrhage

目的 探讨二联神经营养方案辅助应用对高血压性脑出血患者疗效及安全性的影响.方法 选取黑龙江省康复医院神经康复科2015年6月至2017年4月收治高血压性脑出血患者共120例,以随机数字表法分为对照组（60例）和观察组（60例）,分别在基础治疗基础上加用单纯神经节苷脂钠和神经节苷脂＋鼠神经生长因子（nerve growth factor,NGF）方案治疗,比较两组患者近期疗效,治疗前后美国国立卫生员卒中量表（national institute of health stroke scale,NIHSS）评分、脑卒中影响量表（stroke impact scale,SIS）评分、Barthel指数评分、脑水肿面积、血肿量、炎性细胞因子水平、氧化应激指标、髓磷脂碱性蛋白（myelin basic protein,MBP）水平及不良反应发生率.结果 观察组患者近期疗效显著优于对照组（P〈0.05）;观察组患者治疗后脑水肿面积和血肿量均显著优于对照组及治疗前（均P〈0.05）;观察组患者治疗后NIHSS评分、SIS评分及Barthel指数评分均显著优于对照组及治疗前（均P〈0.05）;观察组患者治疗后基质金属蛋白酶-9（matrix metalloproteinases-9,MMP-9）、白细胞介素-8（interleukin-8,IL-8）、肿瘤坏死因子-α（tumor necrosis factor-α,TNF-α）、丙二醛（malonaldehyde,MDA）、超氧化物歧化酶（superoxide dismutase,SOD）及MBP水平均显著优于对照组及治疗前（均P〈0.05）;两组患者不良反应发生率比较差异无统计学意义（P〉0.05）.结论 二联神经营养方案辅助治疗高血压性脑出血患者可有效控制病情进展,促进脑水肿和血肿消退,保护受损神经功能,改善日常生活质量,抑制局部炎症和氧化应激反应,并有助于降低MBP水平。

Objective To investigate the influence of bigeminy nerve nutrition scheme on clinical effects and Laboratory indexes of patients with hypertensive cerebral hemorrhage. Methods A total of 120 pa-tients with hypertensive cerebral hemorrhage from June 2015 to April 2017 in Convalescent Hospital of Hei-longjiang Province were chosen and divided into two groups randomly,control group （60 patients）with monosia-lotetrahexosyl ganglioside sodium and observation group （60 patients）with monosialotetrahexosyl ganglioside sodium ＋ NGF on the basis of systematic intervention. The clinical effects index and adverse reactions inci-dence of both groups were compared,and clinical effects index including short-term clinical effects ,NIHSS score,SIS score,Barthel index score,cerebral edema area,hematoma volume,the levels of inflammatory cytokine level,oxidative stress index and MBP before and after treatment were also analysised. Results The clinical short-term effects of observation group were significantly better than that of control group（P 〈 0. 05）. The NIH-SS score,SIS score and Barthel index score after treatment of observation group were significantly better than these of control group and before treatment patients （P 〈 0. 05）. At the same time,the cerebral edema area and hematoma volume after treatment of observation group were better （P 〈 0. 05）. The levels of matrix metallopro-teinases-9（MMP-9）,interleukin-8（IL-8）,tumor necrosis factor-α（TNF-α）,malonaldehyde（MDA）,superoxide dismutase（SOD）and myelin basic protein（MBP）after treatment in observation group were significantly better than these of control group and before treatment patients too（P 〈 0. 05）. There was no significant difference in the adverse reaction incidence between two groups（P 〉 0. 05）. Conclusion Bigeminy nerve nutrition scheme in the treatment of patients with hypertensive cerebral hemorrhage can efficiently control the disease progress and promote the regression of brain edema and hematoma,then this scheme should also protect the damaged nerve function,improve the quality of daily life,inhibit the local inflammation and oxidative stress reaction and reduce the levels of MBP for patients with hypertensive cerebral hemorrhage.