神经生长因子经鼻脑靶向联合腰大池外引流治疗外伤性蛛网膜下腔出血临床观察  

Intranasal brain targeting of nerve growth factor combined with lumbar cistern drainage for traumatic subarachnoid hemorrhage

作　　者：张慧[1] 步星耀[2] 杨冬谊 焦继超[3] 李志营[3] 袁强[2] 孙彦熙 马玉德[3] 

机构地区：[1]河南中医学院基础医学院,2013级郑州450046 [2]郑州大学人民医院河南省人民医院神经外科,郑州450003 [3]郑州市第七人民医院神经外科,450006

出　　处：《中华实用诊断与治疗杂志》2015年第12期1234-1236,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河南省科技发展计划项目(132300410366);河南省基础与前沿技术研究项目(142300410266)

摘　　要：目的探讨神经生长因子(nerve growth factor,NGF)经鼻脑靶向联合腰大池外引流治疗外伤性蛛网膜下腔出血(traumatic subarachnoid hemorrhage,tSAH)的疗效和安全性。方法 70例tSAH患者随机分为对照组和观察组各35例,对照组给予止血、预防血管痉挛、保护神经和对症支持等常规治疗,观察组在对照组治疗基础上给予鼠神经生长因子18μg+生理盐水2mL溶解稀释后滴鼻,1支/d,连续4周,并行腰大池外引流治疗。分别于治疗前及治疗28d评定2组神经功能缺损评分(National Institutes of Health Stroke Score,NIHSS),比较2组脑血管痉挛、脑积水发生率。结果治疗28d,观察组、对照组NIHSS评分(18.26±2.33、21.02±1.71)均较治疗前(24.86±3.85、24.39±4.07)降低(P<0.05),且观察组低于对照组(P<0.05);对照组脑血管痉挛发生率(57.14%)、脑积水发生率(40.0%)均高于观察组(20.0%、5.7%)(P<0.05)。结论 NGF经鼻脑靶向联合腰大池外引流术治疗可改善tSAH患者神经功能,降低tSAH后脑血管痉挛和脑积水的发生率。Objective To investigate the clinical efficacy and safety of intranasal brain targeting of nerve growth factor （NGF） combined with lumbar cistern drainage for traumatic subarachnoid hemorrhage （tSAH）. Methods Seventy patients were randomly divided into observation group and control group, with 35 patients in each group. Control group was given conventional treatment including hemostasis, preventing vasospasm, neuroprotection and symptomatic support. Based on the treatment in control group, observation group received nasal administration of dilute solution of 18μg mouse NGF in 2 mL normal saline, once a day, totally for 4 weeks, besides external lumbar drainage. National Institutes of Health Stroke Score （NIHSS） values were assessed in two groups before and after 28-day treatment respectively, and the incidences of cerebral vasospasm and hydrocephalus were compared between two groups. Results After 28-day treatment, the NIHSS values were significantly lower in observation group （18.26±2.33） and control group （21.02±1.71） than those before treatment （24. 86±3.85, 24. 39±4.07） respectively （P〈0.05）, which was more obvious in observation group than in control group （P〈0.05）. The incidences of cerebral vasospasm and hydrocephalus were significantly higher in control group （57.14%, 40.0%） than those in observation group （20.0%, 5.7%） （P〈0.05）. Conclusion Intranasal brain targeting of NGF combined with lumbar cistern drainage can significantly improve the neurological function and reduce the incidences of cerebral vasospasm and hydrocephalus after tSAH.

关 键 词：外伤性蛛网膜下腔出血 神经生长因子 腰大池外引流术 经鼻脑靶向治疗 

分 类 号：R651.1[医药卫生—外科学]