后路减压内固定联合mNGF对老年胸腰椎骨折伴脊髓损伤患者脊髓功能及血清mRNA-124、Neuritin的影响  

Effects of posterior decompression and internal fixation combined with mNGF on spinal cord function and serum mRNA-124 and Neuritin in elderly patients with thoracolumbar fracture and spinal cord injury

作　　者：朴美慧 PIAO Mei-hui(Department of Orthopedics,Northern Theater General Hospital,Shenyang 110016,China)

机构地区：[1]北部战区总医院骨科,辽宁沈阳100016

出　　处：《社区医学杂志》2022年第16期912-918,共7页Journal Of Community Medicine

摘　　要：目的探讨后路减压内固定联合注射用鼠神经生长因子(mNGF)对老年胸腰椎骨折伴脊髓损伤患者脊髓功能及对血清mRNA-124、神经突起因子(Neuritin)的影响。方法选取2018-01-16-2020-10-28北部战区总医院收治的老年胸腰椎骨折伴脊髓损伤患者120例,依据随机数字表法分为观察和对照2组,每组60例。2组患者均接受后路减压内固定手术,其中对照组甲泼尼龙治疗,而观察组采用加注射用鼠神经生长因子联合甲泼尼龙治疗。比较2组患者治疗后的疗效和不良反应发生情况,以及治疗前后脊髓损伤和脊髓功能指标、生活质量以及血清mRNA-124、Neuritin水平情况。结果治疗后,观察组治疗优良率86.67%显著高于对照组71.67%,差异有统计学意义,χ^(2)=4.090,P<0.05。2组患者的针刺觉、轻触觉和运动觉评分显著增加,观察组高于对照组,差异有统计学意义,F值分别为6.614、5.972和5.586,均P<0.05。重复测量方差分析显示,不同时间mRNA-124、Neuritin水平差异有统计学意义(F_(时间)值分别为14.631和18.258,均P_(时间)<0.001),治疗14 d后,mRNA-124、Neuritin水平显著增加,28 d后各水平显著降低;2组mRNA-124、Neuritin水平比较,差异有统计学意义(F_(组间)值分别为10.210和20.158,均P_(组间)<0.001),2组mRNA-124、Neuritin水平变化趋势比较,差异有统计学意义,F_(组间)值分别为26.241和32.524,均P_(组间)<0.001。2组患者的心理评分、躯体评分显著增加,观察组高于对照组,F值分别为5.598和5.630,均P<0.001。观察组不良事件发生率10.00%与对照组11.67%比较,差异无统计学意义,χ^(2)=40.090,P>0.05。结论后路减压内固定联合mNGF对老年胸腰椎骨折伴脊髓损伤患者疗效显著,可有效改善mRNA-124、Neuritin水平,从而加速骨折愈合,促进脊髓神经功能,提高患者生活质量。Objective To study the effects of posterior decompression and internal fixation combined with mouse never growth factor(mNGF)on spinal cord function and serum mRNA-124and Neuritin in elderly patients with thoracolumbar fracture and spinal cord injury.Methods Totally 120cases of elderly patients with thoracolumbar fracture and spinal cord injury were treated in Northern Theater General Hospital from January 16,2018October 28,2020were selected and divided into observation group and control group according to random digital table,with 60cases per group.The patients in both groups were treated with posterior decompression and internal fixation.The control group was treated with methylprednisolone,while the observation group was treated with injection of mNGF and methylprednisolone.The efficacy,adverse reactions,spinal cord injury and spinal cord function index,quality of life and serum mRNA-124,Neuritin level were compared between the two groups after treatment.Results After treatment,the excellent and good rate in the observation group(86.67%)was significantly higher than that in the control group(71.67%),with statistical significance(χ^(2)=4.090,P<0.05).The scores of acupuncture sensation,light tactile sensation and motor sensation in the two groups were significantly increased,and the scores in each observation group were significantly higher than those in the control group(F=6.614,5.972,5.586,P<0.05).There were significant differences in the levels of mRNA-124and Neuritin at different times(F_(time)=14.631,18.258,P_(time)<0.001).The levels of m-RNA124and Neuritin increased significantly after 14days of treatment and decreased significantly after 28days of treatment;There was significant difference in the levels of mRNA-124and Neuritin between the two groups(F_(group)=10.210,20.158,P_(group)<0.001).The change trend of mRNA-124and Neuritin levels in the two groups was statistically significant(F_(time`group)=26.241,32.524,P_(time`group)<0.001).The psychological score and somatic score of the two groups were signif

关 键 词：神经生长因子 老年胸腰椎骨折 脊髓损伤 mRNA-124 神经突起因子 

分 类 号：R687.3[医药卫生—骨科学]