鼠神经生长因子联合依达拉奉治疗一氧化碳中毒疗效及对氧自由基有关指标的影响  

Efficacy of mouse nerve growth factor combined with edaravone in the treatment of carbon monoxide poisoning and its influence on oxygen free radical-related indicators

作　　者：王书英[1] 冯庆芝[2] 郭庆争[1] 贾娅 Wang Shuying;Feng Qingzhi;Guo Qingzheng;Jia Ya(Department of Emergency,the Huxi Hospital Affilliated Jining Medical College,Heze 274300,China;Emergency Department of Heze Municipal Hospital,Heze 274300,China)

机构地区：[1]济宁医学院附属湖西医院急诊内科,菏泽274300 [2]菏泽市立医院急诊科,菏泽274100

出　　处：《中国医师进修杂志》2023年第2期112-118,共7页Chinese Journal of Postgraduates of Medicine

摘　　要：目的:探讨鼠神经生长因子与依达拉奉结合治疗一氧化碳中毒疗效及对患者认知功能、乳酸清除率、氧自由基有关指标的影响。方法:选取2017年5月至2020年6月济宁医学院附属湖西医院一氧化碳中毒患者158例,依据治疗方案分为研究组80例,对照组78例。两组均采取常规治疗,于此基础上对照组予以依达拉奉,研究组予以鼠神经生长因子联合依达拉奉,均治疗2周。对比两组临床疗效与治疗前以及治疗1周、2周后神经功能缺损程度评分[美国国立卫生研究院卒中量表(NIHSS)]、病情严重程度评分[急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)]、认知功能评分[简易智能精神状态检查量表(MMSE)]、血清炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)]、氧自由基有关指标[脂质过氧化物(LPO)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-PX)、丙二醛(MDA)]水平、治疗前血乳酸水平以及治疗12、24和72 h后乳酸清除率,并统计不良反应发生情况与30 d病死情况。结果:研究组治疗2周后总有效率高于对照组[95.00%(76/80)比78.21%(61/78)](P<0.05);研究组治疗1周、2周后NIHSS、APACHEⅡ评分低于对照组[(6.08±1.15)分比(8.94±1.71)分、(4.58±0.74)分比(6.32±0.93)分和(6.79±1.03)分比(8.02±1.47)分、(5.94±0.82)分比(7.25±0.94)分],MMSE高于对照组[(22.09±4.35)分比(19.34±5.32)分、(26.05±2.37)分比(22.47±4.64)分](P<0.05);研究组治疗1、2周后血清TNF-α、IL-6、CRP、LPO、MDA水平低于对照组[(22.62±4.12)ng/L比(29.43±4.68)ng/L和(18.21±2.09)ng/L比(24.37±3.16)ng/L、(39.67±4.35)ng/L比(52.14±5.48)ng/L和(34.83±3.75)ng/L比(41.07±4.09)ng/L、(12.63±1.85)mg/L比(17.02±2.47)mg/L和(8.27±1.16)mg/L比(11.05±1.62)mg/L、(11.06±1.28)μmol/L比(15.97±1.85)μmol/L和(8.24±1.12)μmol/L比(12.97±1.40)μmol/L、(7.15±1.16)μmol/L比(9.02±1.47)μmol/L和(6.12±0.96)μmol/L比(7.84±1.25)μmol/L],SOD、Objective To investigate the therapeutic effect of the combination of mouse nerve growth factor and edaravone in the treatment of carbon monoxide poisoning and its effect on patients′cognitive function,lactic acid clearance rate,and related indicators of oxygen free radicals.Methods A selection of 158 patients with carbon monoxide poisoning in the Huxi Hospital Affilliated Jining Medical College from May 2017 to June 2020 were divided into study group(80 cases)and control group(78 cases)according to the treatment plan.Both groups were given conventional treatment.On this basis,the control group was given edaravone,and the study group was given mouse nerve growth factor combined with edaravone,both of which were treated for 2 weeks.The clinical efficacy of the two groups was compared with those before treatment and 1 week and 2 weeks after treatment.Neurological impairment score(NIHSS),disease severity score(APACHEⅡ),cognitive function score(MMSE),serum inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)],oxygen free radical related indicators[lipid peroxide(LPO),superoxide dismutase(SOD),gluten Glutathione peroxidase(GSH-PX),malondialdehyde(MDA)]levels,blood lactic acid levels before treatment and lactic acid clearance rates after 12 h,24 h,72 h treatment,and statistics of adverse reactions and 30-day mortality.Results The total effective rate of the study group was higher than that of the control group after 2 weeks of treatment[95.00%(76/80)vs.78.21%(61/78)](P<0.05);NIHSS and APACHEⅡscores of the study group after 1 week and 2 weeks of treatment Lower than the control group:(6.08±1.15)points vs.(8.94±1.71)points,(4.58±0.74)points vs.(6.32±0.93)points and(6.79±1.03)points vs.(8.02±1.47)points,(5.94±1.47)points vs.(7.25±0.94)points,the MMSE score was higher than that of the control group:(22.09±4.35)points vs.(19.34±5.32)points,(26.05±2.37)points vs.(22.47±4.64)points(P<0.05)After 1 and 2 weeks of treatment,the serum TNF-α,IL-6,CRP,LPO and MDA level

关 键 词：依达拉奉 一氧化碳中毒 鼠神经生长因子 认知功能 乳酸清除率 氧自由基 

分 类 号：R595.1[医药卫生—内科学]