鼠神经生长因子联合尼莫地平对高血压脑出血患者神经功能缺损疗效及血清炎性因子水平影响

Effects of mouse nerve growth factor combined with nimodipine on neurological defects and its influence on serum inflammatory factors in patients with hypertensive cerebral hemorrhage

目的探讨注射鼠神经生长因子联合尼莫地平对高血压脑出血患者神经功能缺损的治疗效果及对血清炎性因子水平的影响。方法选取自2017年3月至2019年1月收治的100例高血压脑出血患者为研究对象,采用随机数字表法分为A组与B组,每组各50例。两组患者均给予绝对卧床、吸氧及控制血压、血糖等常规治疗,并给予20%甘露醇静脉滴注。此外,A组患者给予尼莫地平治疗,B组患者给予鼠神经生长因子联合尼莫地平治疗。两组患者均治疗2周。观察并比较两组患者临床疗效及不良反应发生情况;治疗前、治疗后,比较两组患者美国国立卫生研究院卒中量表(NIHSS)评分、日常生活活动能力(ADL)评分、脑水肿带体积、血肿体积及血清炎性因子[高迁移率族蛋白B1(HMGB1)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)]水平。结果B组患者治疗有效率为90.0%(45/50),显著高于A组的66.0%(33/50),差异有统计学意义(P<0.05)。治疗后,两组患者NIHSS评分均低于治疗前,且B组低于A组;两组患者ADL评分均高于治疗前,且B组高于A组,差异有统计学意义(P<0.05)。治疗后,两组患者脑水肿带体积、血肿体积均小于治疗前,且B组小于A组,差异有统计学意义(P<0.05)。治疗后,两组患者血清HMGB1、IL-6、TNF-α水平均低于治疗前,且B组低于A组,差异有统计学意义(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)。结论鼠神经生长因子联合尼莫地平治疗高血压脑出血神经功能缺损的临床疗效显著,能明显缩小脑水肿带体积、血肿体积,降低炎性因子水平,减轻神经功能损伤,有助于日常生活功能恢复。

Objective To investigate the effect of injecting mouse nerve growth factor combined with nimodipine on neurological defects and its influence on serum inflammatory factors in patients with hypertensive cerebral hemorrhage.Methods A total of 100 patients with hypertensive cerebral hemorrhage admitted from March 2017 to January 2019 were selected and divided into Group A and Group B by random number table,with 50 cases in each group.Both groups of patients were given conventional treatments,such as strict bed rest,oxygen inhalation,blood pressure control,blood glucose control,and 20%mannitol intravenous drip.In addition,patients in Group A were treated with nimodipine,and patients in Group B were treated with mouse nerve growth factor combined with nimodipine.Patients in both groups were treated for 2 weeks.The clinical efficacy and the occurrence of adverse reactions between the two groups of patients were observed and compared.Before and after the treatment,the National Institutes of Healthstroke scale(NIHSS)score,activities of daily living(ADL)score,cerebral edema zone volume,hematoma volume and serum inflammatory factors[high mobility group protein B1(HMGB1),interleukin 6(IL-6),tumor necrosis factorα(TNF-α)]levels were compared between the two groups.Results The effective rate of treatment in Group B was 90.0%(45/50),which was significantly higher than that in Group A[66.0%(33/50)],the difference was statistically significant(P<0.05).After treatment,the NIHSS scores of the two groups were lower than before,and that in Group B was lower than that in Group A;the ADL scores of the two groups were higher than before,and that in Group B was higher than that in Group A,the differences were statistically significant(P<0.05).After treatment,the cerebral edema zone volume and hematoma volume of the two groups were lower than before,and those in Group B were lower than those in Group A,the differences were statistically significant(P<0.05).After treatment,the serum HMGB1,IL-6 and TNF-αlevels of the two groups were lower than before,and the serum HMGB1,IL-6 and TNF-αlevels of Group B were lower than those of Group A,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The clinical effect of mouse nerve growth factor combined with nimodipine on neurological defects in patients with hypertensive cerebral hemorrhage is significant.It can significantly reduce the cerebral edema zone volume,hematoma volume and the level of inflammatory factors,reduce nerve function damage,and help to recover daily life function.