维生素B_(12)联合鼠神经生长因子治疗脑瘫患儿的疗效

Effect of vitamin B_(12) combined with mouse nerve growth factor in children with cerebral palsy

目的研究维生素B_(12)(Vit B_(12))联合鼠神经生长因子治疗脑瘫患儿的疗效及对细胞凋亡的影响。方法选择64例痉挛型脑瘫患儿,随机分为对照组(接受鼠神经生长因子治疗)和观察组(接受Vit B_(12)联合鼠神经生长因子治疗)。治疗前及治疗后6个月,分别进行粗大运动功能分级系统(GMFCS)分级、粗大运动功能评估量表88项(GMFM-88)评分和改良Tardieu量表(MTS)评分,用经颅彩色多普勒检测2组患儿大脑中动脉(MCA)的收缩期峰流速(V_(s))、平均血流速(V_(m))、血管阻力指数(RI),采用酶联免疫吸附法(ELISA)检测血清同型半胱氨酸(Hcy)、Vit B_(12)、含半胱氨酸的天冬氨酸蛋白水解酶-3(caspase-3)、Bcl-2相关X蛋白(Bax)水平。结果治疗后,观察组患儿的GMFCS分级、MTS评分、MCA的RI及血清Hcy、caspase-3、Bax水平均低于对照组,GMFM-88评分、MCA的V_(s)及V_(m)、血清Vit B_(12)水平高于对照组。结论Vit B_(12)联合鼠神经生长因子治疗痉挛型脑瘫能够改善患儿痉挛状态,可能与降低Hcy含量并抑制细胞凋亡有关。

Objective To study the curative effect of vitamin B_(12)(Vit B_(12))combined with mouse nerve growth factor in treating children with cerebral palsy and its effect on apoptosis.Methods 64 cases of children with spastic cerebral palsy were selected and randomly divided into control group receiving mouse nerve growth factor treatment and observation group receiving Vit B_(12) combined with mouse nerve growth factor treatment.Before and 6 months after treatment,the gross motor function classification system(GMFCS),gross motor function assessment scale 88(GMFM-88)and modified Tardieu scale(MTS)were evaluated,the peak systolic velocity(V_(s)),mean blood velocity(V_(m))and resistance index(RI)of middle cerebral artery(MCA)were detected by transcranial color doppler,and the levels of serum homocysteine(Hcy),Vit B_(12),caspase-3 and Bax were detected by ELISA.Results After treatment,the GMFCS grade,MTS score,RI of MCA and serum Hcy,caspase-3 and Bax levels of the observation group were lower than those of the control group,while the GMFM-88 score,V_(s) and V_(m) of MCA and serum Vit B_(12) levels of the observation group were higher than those of the control group.Conclusion Vit B_(12) combined with mouse nerve growth factor in the treatment of spastic cerebral palsy can improve the spastic state,which may be related to the reduction of Hcy content and inhibition of apoptosis.