醒脑静注射液联合神经生长因子对重症颅脑损伤临床疗效及肝功能的影响

Clinical Efficacy of Xingnaojing Injection Combined with Nerve Growth Factor in Treatment of Patients with Severe Craniocerebral Injury and Its Effect on Liver Function

目的探讨醒脑静注射液联合神经生长因子对重症颅脑损伤(STBI)临床疗效及对肝功能的影响。方法选取2018年2月—2019年11月我院收治的STBI患者120例为研究对象,根据治疗方法不同分为联合组和对照组,每组60例。对照组在常规治疗基础上加用鼠神经生长因子,联合组在对照组基础上联用醒脑静注射液。观察并比较2组治疗前、治疗后14 d血清髓鞘碱性蛋白(MBP)及神经元特异性烯醇化酶(NSE)水平、凝血功能[D-二聚体、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)]、肝功能相关指标[丙氨酸转氨酶(ALT)、总胆红素(TBIL)]、超敏C反应蛋白(hs-CRP)水平。比较2组临床疗效及并发症发生率。结果与治疗前比较。2组治疗后血清NSE、MBP水平降低,且联合组低于对照组,差异有统计学意义(P<0.01)。与治疗前比较,2组治疗后14 d格拉斯哥昏迷量表评分增高、美国国立卫生研究院卒中量表、急性生理学和慢性健康状况评分系统Ⅱ评分明显降低,且联合组优于对照组,差异有统计学意义(P<0.01)。与治疗前比较,2组治疗后14 d的PT、APTT时间缩短,且联合组短于对照组,差异有统计学意义(P<0.01)。与治疗前比较,2组治疗后14 d,D-二聚体、ALT、TBIL及hs-CRP水平下降,且联合组低于对照组,差异有统计学意义(P<0.01)。联合组住院期间并发症发生率及治疗后3个月格拉斯哥预后量表优良率均优于对照组(P<0.05)。结论STBI患者采用醒脑静注射液联合神经生长因子具有较好的治疗效果,可以降低并发症发生率,改善凝血功能,对肝功能的影响低,安全性较高。

Objective To investigate clinical efficacy of Xingnaojing Injection combined with nerve growth factor(NGF)in treatment of patients with severe craniocerebral injury(SCCI)and its effect on liver function.Methods A total of 120 patients with SCCI admitted during February 2018 and November 2019 were selected and divided into combination group(n=60)and control group(n=60)according to different therapeutic methods.Control group was given rats'NGF on the basis of conventional treatment,while combination group was supplemented with Xingnaojing Injection on the basis of treatment for control group.Levels of serum myelin basic protein(MBP)and neuron specific enolase(NSE),coagulation function indexes[D-dimer(DD),prothrombin time(PT),activated partial thromboplastin time(APTT)],liver function related indicators[alanine transarninase(ALT),total bilirubin(TBIL)]and high sensitivity C-reactive protein(hs-CRP)levels were observed and compared before and after treatment for 14 d in two groups.Clinical efficacy and incidence rate of complications were compared in two groups.Results After treatment,serum levels of NSE and MBP were significantly decreased compared with those before treatment in two groups,and the levels in combination group were significantly lower than those in control group(P<0.01).After treatment for 14 d,scores of Glasgow Coma Scale(GCS),National Institutes of Health Stroke Scale(NIHSS)and Acute Physiology and Chronic Health Evaluation II(APACHE-Ⅱ)were significantly lower than those before treatment in two groups,and the scores in combination group were better than those in control group(P<0.01).Compared with those before treatment,PT and APTT times were significantly shorter after treatment for 14 d than those before treatment in two groups,and the times in combination group were significantly shorter than those in control group(P<0.01).Compared with those before treatment,levels of DD,ALT,TBIL and hs-CRP were significantly decreased after treatment for 14 d in two groups,and the levels in combination group were significantly lower than those in control group(P<0.01).Incidence rate of complications during hospitalization and the excellent and good rate of GOS after treatment for 3 months in combination group were better than those in control group(P<0.05).Conclusion NGF combined with Xingnaojing injection in treatment of STBI patients may achieve better clinical efficacy,reduce incidence rate of complications and improve coagulation function with less effect on liver function and good safety.