Influence of intravenous thrombolysis with mouse nerve growth factor for injection and recombinant tissue-type plasminogen activator on neurological function of patients with acute cerebral infarction
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摘要:目的 探讨注射用鼠神经生长因子联合重组组织型纤溶酶原激活物(rt-PA)静脉溶栓对急性脑梗死(ACI)患者神经功能及血清神经生长因子(NGF)、髓鞘碱性蛋白(MBP)水平的影响。方法 选取ACI患者98例，随机分为研究组(n=49)与对照组(n=49)。2组入院后均给予常规对症治疗，对照组采用rt-PA静脉溶栓治疗，研究组采用注射用鼠神经生长因子联合rt-PA静脉溶栓治疗。比较2组治疗效果、治疗前后美国国立卫生院神经功能缺损评分(NIHSS)评分、生活质量(SF-36), 比较2组治疗前后血清NGF、MBP及脑源性神经营养因子(BNDF)水平。结果 研究组总有效率95.92%, 显著高于对照组81.63%(P < 0.05)。治疗后，研究组NIHSS评分及血清MBP水平低于对照组, NGF及BNDF水平高于对照组，差异有统计学意义(P < 0.05)。治疗后1个月，研究组活力、精神健康、社会功能及总体健康各项评分均显著高于对照组(P < 0.05)。结论 注射用鼠神经生长因子联合rt-PA静脉溶栓治疗ACI, 能显著提高治疗效果，改善患者神经功能，提高生活质量。
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关键词:
- 急性脑梗死 /
- 注射用鼠神经生长因子 /
- 重组组织型纤溶酶原激活物 /
- 静脉溶栓 /
- 神经功能 /
- 神经生长因子 /
- 髓鞘碱性蛋白
Abstract:Objective To investigate the influence of intravenous thrombolysis with mouse nerve growth factor for injection and recombinant tissue-type plasminogen activator (rt-PA) on neurological function and serum nerve growth factor (NGF), myelin basic protein (MBP) in patients with acute cerebral infarction (ACI).Methods A total of 98 ACI patients were selected and randomly divided into study group (n=49) and control group (n=49). Both groups were treated with conventional symptomatic treatment after hospital admission. On this basis, the control group was treated with rt-PA by intravenous thrombolysis, while the study group was treated with intravenous thrombolysis with mouse nerve growth factor for injection and rt-PA. The therapeutic effect, NIHSS score and quality of life (SF-36) of the two groups were compared before and after treatment. The serum levels of NGF, MBP and brain-derived neurotrophic factor (BNDF) of the two groups were compared before and after treatment.Results The total effective rate of the study group was 95.92%, which was significantly higher than 81.63% of the control group (P < 0.05). After treatment, the NIHSS score and serum MBP level of the study group were significantly lower than those of the control group, and the levels of NGF and BNDF were significantly higher than those of the control group (P < 0.05). One month after treatment, the scores of vitality, mental health, social function and overall health in the study group were significantly higher than those in the control group (P < 0.05).Conclusion Application of intravenous thrombolysis with mouse nerve growth factor for injection and rt-PA can significantly improve the therapeutic effect, neurological function and quality of life in patients with ACI. -
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表 1 2组基线资料对比(x±s)[n(%)]
基线资料 研究组(n=49) 对照组(n=49) 年龄/岁 65.38±7.53 66.17±8.06 性别 女 22 20 男 27 29 发病至溶栓时间/h 3.57±0.89 3.72±0.93 脑梗死灶体积/cm3 41.75±3.28 42.31±3.49 合并症 高血压 22(44.90) 20(40.82) 糖尿病 14(28.57) 15(30.61) 高血脂 13(26.53) 14(28.57) 梗死类型 皮质型 16(32.65) 14(28.57) 皮质下型 25(21.02) 26(53.06) 混合型 8(16.33) 9(18.37) 梗死部位 脑干 19(38.78) 20(40.82) 单侧颞顶叶 15(30.61) 13(26.53) 单侧额颞叶 9(18.37) 8(16.33) 丘脑 6(12.24) 8(16.33) 
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表 2 2组临床疗效比较[n(%)]
组别 n 无效 好转 显效 基本痊愈 总有效 研究组 49 2(4.08) 12(24.49) 22(44.90) 13(26.53) 47(95.92)* 对照组 49 9(18.37) 15(30.61) 19(38.78) 6(12.24) 40(81.63) 与对照组比较, *P < 0.05。
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表 3 2组治疗前后NIHSS评分比较(±s)
分 组别 n 治疗前 治疗后 研究组 49 27.39±6.48 7.94±5.37*# 对照组 49 26.54±6.62 11.53±6.82* 与治疗前比较, *P < 0.05; 与对照组比较, #P < 0.05。
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表 4 2组生活质量评分对比(x±s)
分 组别 时点 活力 精神健康 社会功能 总体健康 研究组(n=49) 治疗前 53.81±10.42 54.74±11.23 51.26±10.35 56.85±5.76 治疗后1个月 77.29±13.35* 79.40±13.18* 74.51±11.24* 76.95±12.41* 对照组(n=49) 治疗前 54.39±10.17 55.42±11.39 52.17±9.84 57.34±6.12 治疗后1个月 67.59±13.04 69.52±12.47 62.26±10.73 67.38±11.29 与对照组比较, *P < 0.05。
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表 5 2组血清指标对比(x±s)
组别 时点 NGF/(pg/mL) MBP/(μg/L) BNDF/(ng/mL) 研究组(n=49) 治疗前 118.35±13.76 2.70±0.41 3.19±0.62 治疗后 143.97±16.38* 1.36±0.35* 5.49±0.73* 对照组(n=49) 治疗前 119.47±14.28 2.63±0.37 3.22±0.58 治疗后 131.52±15.71 2.09±0.38 4.37±0.68 NGF: 神经生长因子; MBP: 髓鞘碱性蛋白; BNDF: 脑源性神经营养因子。与对照组比较, *P < 0.05。
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