尼莫地平联合神经生长因子治疗脑出血的疗效及对血清HIF-1α、NSE水平的影响  

Therapeutic Effect of Nimodipine Combined with Nerve Growth Factor on Patients with Cerebral Hemorrhage and Its Influence on Serum HIF-1αand NSE Levels

作　　者：李莉[1] 董海青[1] 贺建辉[1] 李鑫[1] 田宇慧 韦秋红 LI Li;DONG Haiqing;HE Jianhui;LI Xin;TIAN Yuhui;WEI Qiuhong(Department of Neurosurgery,Baoding First Central Hospital,Baoding 017000,China)

机构地区：[1]保定市第一中心医院神经外科,河北保定071000

出　　处：《医学综述》2020年第12期2452-2457,共6页Medical Recapitulate

基　　金：保定市科技支撑计划项目(17ZF260)。

摘　　要：目的探讨尼莫地平联合神经生长因子治疗脑出血的疗效及对血清缺氧诱导因子-1α(HIF-1α)、神经元特异性烯醇化酶(NSE)水平的影响。方法回顾性分析2017年1月至2018年5月保定市第一中心医院收治的120例脑出血患者的临床资料,按照治疗方法不同分为观察组和对照组,各60例。其中,对照组单独使用尼莫地平治疗,观察组在对照组的基础上联合使用神经生长因子进行治疗,4周为1个疗程,两组患者均治疗2个疗程。比较两组患者的临床疗效,治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、血清HIF-1α、NSE、炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6、IL-8]、应激指标[肾素、肾上腺素(E)、血管紧张素Ⅱ(AngⅡ)、去甲肾上腺素(NE)]水平。结果观察组的总有效率高于对照组[86. 67%(52/60)比55. 00%(33/60)](P <0. 05)。治疗后,两组患者的NIHSS评分呈下降趋势,且观察组各时间段均低于对照组(P <0. 01)。治疗后,两组患者的HIF-1α、NSE水平均下降,且观察组低于对照组[(1.43±0.29)μg/L比(2.06±0.97)μg/L,(9.85±1.81)μg/L比(15.89±1.79)μg/L](P <0. 01)。治疗后,两组患者的TNF-α、IL-6、IL-8水平均明显下降,且观察组低于对照组[(2. 11±0. 46)μg/L比(4. 15±0. 44)μg/L,(15. 85±7. 81)μg/L比(30. 89±7. 79)μg/L,(11. 67±3. 55)μg/L比(37. 69±9. 57)μg/L](P <0. 05)。治疗后,两组患者的肾素、E、AngⅡ、NE水平均升高,但观察组低于对照组[(1. 84±0. 44) ng/L比(2. 68±0. 43) ng/L,(46. 27±4. 72) g/L比(54. 25±4. 06) g/L,(26. 36±4. 69) ng/L比(38. 69±5. 13) ng/L,(242. 62±27. 99) g/L比(284. 44±34. 55) g/L](P <0. 01)。结论尼莫地平联合神经生长因子治疗脑出血疗效显著,患者的血清HIF-1α、NSE水平及炎症反应指标显著下降。Objective To explore the therapeutic effect of nimodipine combined with nerve growth factor on cerebral hemorrhage and its effect on the level of serum hypoxia inducible factor-1α(HIF-1α)and neuron specific enolase(NSE).Methods 120 patients with cerebral hemorrhage admitted to Baoding First Central Hospital From Jan.2017 to May 2018 were included.According to different treatment methods,they were divided into an observation group and a control group,60 cases each.The control group was treated with nimodipine alone,and the observation group was treated with nerve growth factor on the basis of the control group,4 weeks as a course of treatment,both groups were treated for 2 courses.The clinical efficacy of the two groups,National Institutes of Health stroke scale(NIHSS)score,the level of serum HIF-1α,NSE,inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin(IL)-6,IL-8],stress indicators[renin,adrenaline(E),angiotensinⅡ(AngⅡ)and noradrenaline(NE)]before and after treatment were compared.Results The total effective rate of the observation group was higher than that of the control group[86.67%(52/60)vs 55.00%(33/60)](P<0.05).After treatment,NIHSS score of both groups showed a downward trend,and the observation group was lower than the control group in each time period(P<0.01).After treatment,the levels of HIF-1αand NSE in both groups decreased,and the observation group was lower than the control group[(1.43±0.29)μg/L vs(2.06±0.97)μg/L,(9.85±1.81)μg/L vs(15.89±1.79)μg/L](P<0.01).After treatment,TNF-α,IL-6,IL-8 levels in both groups decreased significantly,and the observation group was lower than the control group[(2.11±0.46)μg/L vs(4.15±0.44)μg/L,(15.85±7.81)μg/L vs(30.89±7.79)μg/L,(11.67±3.55)μg/L vs(37.69±9.57)μg/L](P<0.05).After treatment,the levels of renin,E,AngⅡand NE in both groups increased,but the level in the observation group was lower than that in the control group[(1.84±0.44)ng/L vs(2.68±0.43)ng/L,(46.27±4.72)g/L vs(54.25±4.06)g/L,(26.36±4.69)ng/L vs(38.69±5

关 键 词：急性脑出血 尼莫地平 神经生长因子 缺氧诱导因子-1Α 神经元特异性烯醇化酶 

分 类 号：R743.34[医药卫生—神经病学与精神病学]