鼠神经生长因子联合甲钴胺治疗合并足下垂的腰椎间盘突出症  

Combination of mouse nerve growth factor and mecobalamin in the treatment of lumbar disc herniation patients with foot drop

作　　者：林红[1] 姜允琦[1] 李超[1] 马易群[1] 李熙雷[1] 周晓岗[1] 董健[1] 

机构地区：[1]复旦大学附属中山医院骨科,上海200032

出　　处：《中华神经医学杂志》2013年第9期936-939,共4页Chinese Journal of Neuromedicine

基　　金：国家自然科学基金（30970718）;上海市医学领军人才项目（LJ10017）

摘　　要：目的探讨鼠神经生长因子（mNGF）在合并足下垂的腰椎间盘突出症患者中的应用价值。方法对复旦大学附属中山医院骨科自2008年1月至2011年6月进行手术治疗的76例合并足下垂的腰椎间盘突出症患者的临床资料进行回顾性分析，其按照术后处理方法不同分为2组：联合组36例（应用mNGF联合甲钴胺治疗1、单纯组40例f单纯应用甲钴胺治疗）。分析患者治疗后一般情况，比较2组治疗后1周、4周、12周、12个月时视觉模拟评分（VAS）和神经功能（感觉功能和肌力1恢复情况。结果患者获得12～54个月（平均24．8个月）随访，无一例死亡，均无创口感染，平均8个月时植骨融合。治疗后1周、4周、12周及12个月时2组VAS评分均明显低于治疗前。且各时间点联合组VAS评分亦明显低于单纯组，差异有统计学意义（P〈0．05）。治疗后1周、4周、12周及12个月时联合组感觉功能改善有效率均明显优于单纯组，差异有统计学意义（P〈0．05）；除1周外其余时间点联合组肌力改善有效率均明显优于单纯组，差异有统计学意义（P〈0．05）。结论mNGF与甲钴胺联合使用能促进合并足下垂的腰椎间盘突出症患者的神经功能恢复。Objective To investigate the effect of mouse nerve growth factor （mNGF） on treatment of patients with lumbar disc herniation combined with foot drop. Methods The clinical data of 76 patients suffering from lumbar disc herniation combined with foot drop, admitted to our hospital from January 2008 and June 2011, were retrospectively analyzed. The patients were divided into two groups according to the postoperative treatments; in particular, one group of 36 patients was treated with a combination of mNGF and methylcobalamin （Group C）, whereas the other group of 40 patients was treated with methylcobalamin alone （Group A）. The visual analogue scale （VAS） scores and the recovery of neurological function among these patients at 1, 4 and 12 weeks, and 12 months after surgery were recorded and compared. Results The follow-up duration ranged from 12 to 54 months （mean 24.8 months）. For both groups, patients＇ VAS scores at observation each time point were lower than their VAS scores prior to treatment （P〈0.05）; moreover, the VAS scores of Group C were significantly lower than Group A at every time point （P〈0.05）. Higher effective rates of sensory improvement were observed in Group C than those in in Group A and exhibited statistically significant differences at each time point （P〈0.05）. The effective rate of muscular strength improvement of the two groups didn＇t differ significantly at 1 week after surgery （P〉0.05） but exhibited statistically significant differences at subsequent time points （P〈 0.05）. Conclusion Application of mNGF in combination with methylcobalamin promotes the recovery of neurological function in patients suffering from lumbar disc herniation with foot drop.

关 键 词：腰椎间盘突出症 足下垂 神经生长因子 甲钴胺 

分 类 号：R681.5[医药卫生—骨科学]