鼠神经生长因子肌肉注射治疗脑性瘫痪高危儿运动障碍的临床观察

Clinical observation of intramuscular injection of mouse nerve growth factor for treatment of dyskinesia of infants with high-risk cerebral palsy

目的探究鼠神经生长因子(MNGF)肌肉注射对脑性瘫痪(CP)高危儿运动功能的影响。方法选取2016年12月至2018年12月内江市第一人民医院收治的脑瘫高危儿100例,分为肌肉注射组和常规组,各50例。常规组采用常规康复训练,肌肉注射组在常规组基础上给予注射用MNGF;治疗前后对所有患儿进行贝利婴幼儿发育量表测试,比较治疗前后运动发展指数(PDI)所得分数及运动功能。采用Peabody运动发育量表评价两组患儿运动功能;比较两组不良反应发生率。结果肌肉注射组的治疗有效率高于常规组,差异有统计学意义(χ^(2) =6.353,P<0.05);随访2年后,肌肉注射组50例患儿中无脑瘫病例发生,常规组50例患儿有3例发生脑瘫,脑瘫发生率为6.00%。治疗后,两组患儿精细运动发育商(FMQ)、粗大运动发育商(GMQ)、总运动商(TMQ)评分均较治疗前显著升高,差异均有统计学意义(肌肉注射组:t值分别为4.062、4.027、4.909;常规组:t值分别为2.264、2.619、3.098,均P<0.05),且肌肉注射组患儿FMQ、GMQ、TMQ评分显著高于常规组,差异均有统计学意义(t值分别为2.347、2.433、2.286,均P<0.05)。两组的不良反应发生率差异无统计学意义(χ^(2)=0.543,P>0.05)。结论脑瘫高危儿连续应用MNGF能够有效预防脑瘫发生,降低脑瘫发生率,显著改善患儿的运动功能。

Objective To investigate effect of mouse nerve growth factor(MNGF) intramuscular injection on motor function of infants with high-risk of cerebral palsy(CP).Methods 100 infants with high-risk of CP who admitted to Department of Pediatrics, Neijiang Municipal First People’s Hospital from December 2016 to December 2018 were selected for clinical observation.The infants were divided into routine treatment group and intramuscular injection group(in each group, n=50).The infants in the routine treatment group received routine rehabilitation training, and those infants in the intramuscular injection group was given MNGF for intramuscular injection on basis of the routine rehabilitation training.Bailey Infant Development Scale was used to test all infants before and after treatment, and scores in psychomotor development index(PDI) and motor function of the infants were compared before and after treatment.Peabody motor development scale was used to evaluate motor function of the infants in the two groups.The adverse reactions were observed and their incidences were compared between the two groups.Results The effective rate of the infants in the intramuscular injection group was higher than that in the routine treatment group, and the difference was statistically significant(χ^(2) =6.353,P<0.05).After 2 years of follow-up, no CP occurred in 50 infants in the intramuscular injection group;while 3 cases of CP occurred in 50 infants in the routine treatment group, and the incidence of CP was 6.00%.After treatment, scores of the infants in the two groups in fine motor development quotient(FMQ),gross motor development quotient(GMQ) and total motor development quotient(TMQ) were significantly increased, there were statistically significant differences(for the intramuscular injection group before and after treatment: t=4.062,4.027 and 4.909 respectively;for the routine treatment group before and after treatment: t=2.264,2.619 and 3.098 respectively, all P<0.05),and the scores in FMQ,GMQ and TMQ of the infants in the intramuscular injection group were significantly higher than those of the infants in the routine treatment group, there were statistically significant differences(t=2.347,2.433 and 2.286 respectively, all P<0.05).There was no statistically significant difference in the incidence of adverse reactions(χ^(2) =0.543,P>0.05).Conclusion Continuous administration of MNGF for those infants with high-risk of CP can effectively prevent occurrence of CP,reduce the incidence rate, and significantly improve motor function of the infants.