蛇毒神经生长因子对神经损伤后脊髓前角运动神经元超微结构的保护作用

目的：研究周围神经损伤后神经生长因子对运动神经元的保护作用。方法：采用定位、定量、定时的方法钳夹大耳白免右坐骨神经,于损伤处注射蛇毒 ＮＧＦ ４００ Ｂｕ·ｋｇ－１·ｄ－１,神经损伤术后 １,３,７ｄ和 ２,３,４,６,８周动态观察脊髓腰段伤侧第 Ⅸ板层外侧群的大型运动神经元的超微结构变化,并对线粒体体密度变化进行定量分析。结果：神经损伤术后对照组超微结构的改变比实验组明显加重,实验组超微结构的恢复比对照组快。结论;ＮＧＦ对神经损伤后脊髓前角运动神经元超微结构的恢复有促进作用,从而对运动神经元可起一定的保护和促进恢复作用。     

神经生长因子和甲钴胺联合治疗DPN的疗效观察

糖尿病周围神经病（diabetic peripheral neuropathy,DPN）是糖尿病常见的并发症之一。主要累及感觉神经、运动神经和自主神经,严重影响患者的生活质量。本研究观察我院2006年8月至2008年8月DPN患者40例,比较与人同源的鼠神经生长因子（mouse nerve growth factor,mNGF）和甲钴胺联合治疗与单用甲钴胺治疗的疗效,报道如下。     

神经生长因子治疗正己烷中毒性周围神经病疗效观察

目的 观察神经生长因子治疗正己烷中毒性周围神经病疗效。方法 采用随机双盲、安慰剂平行对照方法。治疗组35例，肌注神经生长因子9000U，1次／日，疗程30天；对照组35例，使用外观完全一样的无活性制剂。结果 治疗组有效率60％，对照组有效率17．14％，差异非常显(X^2＝13．57 P≤0．01)。结论 神经生长因子治疗正己烷统中毒性周围神经病疗效确切，无严重的毒副作用。     

神经生长因子与神经损伤

神经生长因子(NGF)是神经系统最重要的生物活性分子之一。它营养某些神经元并诱导其突起的生长,是神经系统维持正常发育和功能的必要因素。现在积累的许多动物实验资料还表明:NGF 是参与损伤神经再生和功能修复的重要因素,存在着实际应用的可能性。它的有关研究已引起临床医生越来越浓厚的兴趣。由于 NGF 的分子结构、理化性质和生物学功能国内已有专文论述,故本文概要介绍与神经损伤有关的动物实验研究的进展。     

周围神经损伤后局部应用神经生长因子对骨折早期愈合的影响

目的：探讨周围神经损伤后局部应用神经生长因子（nerve growth factor,NGF）对骨折早期愈合的影响。方法以60只胫骨骨折大鼠模型为研究对象,随机分成盐水组、神经损伤盐水组、NGF组、神经损伤NGF组,每组各15只,各选取30肢体,分析周围神经损伤后局部应用神经生长因子对大鼠胫骨骨折早期愈合的影响。结果NGF促进大鼠肌肉恢复,神经损伤侧骨痂量显著高于对侧（P＜0.05）,NGF组、神经损伤NGF组骨小梁排列规则,而其骨痂量低于神经损伤盐水组,但神经损伤盐水组缺乏正常骨小梁结构。结论在伴或不伴神经损伤的骨折大鼠中,对其采用局部注射神经生长因子,均可抑制破骨细胞活动,让成骨能力变强而促进骨折愈合。     

周围神经损伤的简易显微外科修复

周围神经损伤致残率高,早诊治和早手术是提高治愈率的关键。我院于1981年6月～1999年6月,收治周围神经损伤35例共36条神经,应用简易显微外科技术,进行了神经松解减压术、神经束间缝合、神经外膜缝合术、神经移植术等修复,经随访,疗效满意,报告如下：1 对象与方法1．1 一般资料 本组男30例,女5例,年龄16～60岁。损伤神经有挠神经18条、尺神经10条、正中神经4条、坐骨神经2条、腓总神经1条、肩胛神经1条。病程1个月～1年,其中6个月以内有30条神经。1．2 使用器械 全部手术均用自制眼镜式放大镜、显微器械、双极电凝器、8－0、9－0无…     

维拉帕米与神经生长因子促进大鼠坐骨神经再生的协同作用

背景：实验证明周围神经损伤时,轴突的变性与神经元凋亡都与Ca2+的超载有着极其密切的关系。 目的：利用大鼠坐骨神经损伤模型观察L型钙离子通道阻滞剂维拉帕米联合神经生长因子促进周围神经再生的协同作用。 设计、时间及地点：随机对照动物实验,于2007-04/2008-11在辽宁医学院手外科实验室完成。 材料：同系健康雄性SD大鼠32只,体质量220~260 g;维拉帕米为辽宁卫星制药厂产品,国药准字H21022847;神经生长因子为sigma公司产品。 方法：同系SD大鼠32只随机分为4组,每组8只,分别在右侧梨状肌下缘5 mm切断坐骨神经后立即原位缝合造成坐骨神经损伤模型。①维拉帕米+神经生长因子组：腹腔注射维拉帕米4 mg/(kg•d),术侧腓肠肌肉注射神经生长因子0.6 μg/d。②维拉帕米组：腹腔注射维拉帕米4 mg/(kg•d),术侧腓肠肌注射等量生理盐水。③神经生长因子组：术侧腓肠肌注神经生长因子0.6 μg/d,并腹腔注射等量生理盐水。④空白对照组：分别腹腔,肌注等量生理盐水。以左侧坐骨神经为正常对照。 主要观察指标：术后12周对各组再生神经进行大体观察,神经电生理测定,组织学观察及有髓神经纤维计数。 结果：术后12周,维拉帕米+神经生长因子组足部溃疡的出现与愈合以及展抓反射出现的时间均早于其他各组。神经传导速度恢复率和有髓神经纤维计数恢复率分析表明：维拉帕米+神经生长因子组>维拉帕米组>神经生长因子组>空白对照组。光镜和电镜下可见：维拉帕米+神经生长因子组再生的神经纤维最多,轴突较为粗大。有髓神经纤维多,髓鞘完整,优于其他3组。神经纤维直径恢复率分析表明：维拉帕米+神经生长因子组>神经生长因子组>维拉帕米组>空白对照组。 结论：维拉帕米与神经生长因子对促进周围神经形态结构和功能的恢复均具有明显的协同作用。     

神经生长因子治疗重型颅脑损伤的临床观察

目的 观察神经生长因子(NGF)对重型颅脑损伤患者血浆肌酸激酶同工酶BB(CK-BB)动态变化的影响以及临床疗效.方法 将上海交通大学医学院附属第三人民医院神经外科自2006年8月至2008年8月收治的80例重型颅脑损伤患者(GCS≤8分)分成2组,对照组40例采用常规治疗,试验组40例在常规治疗的基础上加用NGF治疗.观察2组患者血浆CK-BB变化,并于伤后6个月按GOS预后评分评定预后,同时比较2组患者的清醒率及清醒时间.结果 治疗后第1、5、10、20、28天试验组患者血浆CK-BB均明显低于对照组,差异有统计学意义(P<0.05).试验组预后情况明显优于对照组,差异有统计学意义(P<0.05).试验组治疗后1个月清醒32例,对照组18例,差异有统计学意义(P<0.05).试验组清醒时间为(12.43±6.25)d,对照组为(15.96±7.58)d,差异有统计学意义(P<0.05).结论 NGF能有效降低重型颅脑损伤患者血浆CK-BB的水平,促进重型颅脑损伤患者的清醒,改善预后.     

肌电诱发电位仪联合康复训练治疗外伤性周围神经损伤

目的探讨肌电图动态监测在外伤所致周围神经损伤电刺激联合康复治疗中的临床价值。方法 86例外伤所致周围神经损伤患儿,随机分为治疗组43例和对照组43例,治疗组给予肌电图定位定量电刺激联合康复治疗,对照组给予低频电脉冲治疗联合康复治疗,在肌电图仪的持续监测下分析2组相应神经在刺激前后的电学变化。结果治疗组桡神经传导速度、正中神经的传导速度、尺神经的传导速度均明显高于对照组和治疗前。2组运动电位潜伏期明显缩短,波幅增大;治疗组治疗效果明显优于对照组。结论外伤所致周围神经损伤患儿应用肌电图仪的定位定量电刺激治疗效果明显,能有效促进周围神经再生及神经功能恢复,值得临床推广使用。     

Substrate-bound nerve growth factor promotes neurite growth in peripheral nerve

Nerve growth factor (NGF), in addition to its well-known effects as a soluble neurite growth-promoting factor, also appears to promote the elongation of neurites when it is adsorbed to tissue culture substrates. Peripheral nerve Schwann cells appear to possess a receptor for NGF on their surfaces which is induced substantially after axotomy. We have found that the adsorption of NGF onto cryostat sections of the distal stump of previously severed sciatic nerve enhances neurite growth over this tissue. This finding, coupled with the two previous observations, suggests that Schwann cell surface NGF receptors serve to bind to NGF-like growth factors so as to provide favorable surfaces for regenerating peripheral nerve axons.     

Effects of local release of hepatocyte growth factor on peripheral nerve regeneration in acellular nerve grafts

Options for reconstructing peripheral nerve gaps after trauma are limited. The acellular nerve is a new kind of biomaterial used to reconstruct the peripheral nerve defect, but its use could be improved upon. We aimed to investigate the effect of adenoviral transfection with hepatocyte growth factor (HGF) on the functional recovery of transected sciatic nerves repaired by acellular nerve grafting. 30 Rats were divided into three groups (10/group) for autografting and acellular grafting, as well as acellular grafting with adenovirus transfection of HGF (1 × 10⁸ pfu) injected in muscles around the proximal and distal allograft coapation. Sciatic functional index (SFI) was evaluated every 4 weeks to week 16 by measuring rat footprints on walking-track testing. The three groups presented initial complete functional loss, followed by slow but steady recovery, with final similar SFIs. Weight of the gastrocnemius and soleus muscles, histologic and morphometric study and neovascularization in the nerve grafts were evaluated at week 16. Autografting gave the best functional recovery, but HGF-treated acellular grafting gave better recovery than acellular grafting alone. Neovascularization was greater with HGF-treated acellular grafting than with autografting and acellular grafting alone. Axonal regeneration distance of autografting on the 20th postoperative day was the longest in the three groups,while that of acellular grafting alone was the smallest. Acellular nerve grafting may be useful for functional peripheral nerve regeneration, and with human HGF gene transfection may improve on acellular grafting alone in functional recovery.     

Neuronal growth factors produced by adult peripheral nerve after injury

Dorsal root ganglion neurons from embryonic rats, co-cultured with endoneurial explants from transected, adult rat sciatic nerve, extended neurites in the absence of exogenous nerve growth factor (NGF). The effect was seen with endoneurial explants from normal adult sciatic nerves or from nerves which had been permanently transected up to 51 days prior to explantation. The rate of outgrowth decreased at 5 and 7 days and reached a minimum at 14 days after transection. A second phase of increased neurite-promoting activity appeared in 28-, 35-, 41- and 51-day posttransection tissue. The early phase, but not the late phase, was partially inhibited by antisera to NGF.     

Nerve growth factor and injured peripheral nerve regeneration

Nerve growth factor （NGF） exhibits many biological activities, such as supply of nutrients, neuroprotection, and the generation and rehabilitation of injured nerves. The neuroprotective and neurotrophic qualities of NGF are generally recognized. NGF may enhance axonal regeneration and myelination of peripheral nerves, as well as cooperatively promote functional recovery of injured nerves and limbs. The clinical efficacy of NGF and its therapeutic potentials are reviewed here. This paper also reviews the latest NGF research developments for repairing injured peripheral nerve, thereby providing scientific evidence for the appropriate clinical application of NGF.     

损伤神经周围注射自体PRP对周围神经损伤的修复效果观察

目的 探讨损伤神经周围注射自体富血小板血浆(platelet-rich plasma,PRP)对周围神经损伤的修复效果。方法 选取2017年1月-2018年7月于本院接受治疗的周围神经损伤患者130例,随机分为手术组、PRP联合组各65例,手术组患者进行显微外科手术,PRP联合组患者在手术基础上注射自体PRP进行治疗; 用酶联免疫吸附实验法检测血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平,用Western blot法检测胰岛素样生长因子1(IGF-1)、血管内皮生长因子(VEGF)表达水平,并对2组患者神经传导速度、下肢运动功能、基本功能优良率以及肌电图疗效进行检测。结果 治疗1、3、6、12个月后PRP联合组患者CRP、TNF-α水平均低于手术组,IGF-1、VEGF表达水平均高于手术组(P<0.05); 治疗1、3、6、12个月后PRP联合组患者感觉、运动神经传导速度、下肢运动功能评分、基本功能恢复优良率、肌电图愈显率均高于手术组(P<0.05)。结论 在手术治疗的基础上注射自体PRP对周围神经损伤患者进行治疗,能够减轻患者炎性损伤程度,上调IGF-1、VEGF的表达水平,加快神经传导速度,促进患者下肢运动功能恢复     

含神经生长因子的壳聚糖导管桥接周围神经缺损的实验研究

目的 应用含有神经生长因子(NGF)的壳聚糖神经导引管作为神经再生室桥接大鼠坐骨神经缺损，观察其对神经再生的作用。方法 选用Wistat大鼠60只，手术造成右后肢坐骨神经长约15mm的缺损，A组以含有NGF的壳聚糖神经导引管桥接神经缺损，B组则单纯采用壳聚糖导管，分别于术后4、12、24周进行大体及显微解剖观察、组织学检查、电镜观察和神经电生理测定。结果 A组在促进神经再生、加快血管化进程、再生神经纤维排列规律化、提高再生神经髓鞘化、加速再生神经功能重建等方面均优于B组。结论 壳聚糖神经导引管可以为大鼠坐骨神经再生提供一个良好的再生微环境，NGF对神经再生有显促进作用。     

依达拉奉联合神经生长因子治疗重型颅脑损伤的疗效分析

目的 探讨依达拉奉联合神经生长因子治疗重型颅脑损伤的疗效。方法 2014年1月至2016年6月收治符合标准的重型颅脑损伤90例,根据治疗方法分为对照组和观察组,各45例。对照组给予常规治疗,观察组在对照组的基础上加用依达拉奉联合神经生长因子;疗程2周。治疗前、治疗后2周采用酶联免疫吸附法测定血清髓鞘碱性蛋白（MBP）、神经元特异性烯醇化酶（NSE）、S100β、白细胞介素-6（IL-6）和超敏C反应蛋白（CRP）水平;采用Image-Pro Plus软件计算CT影像脑水肿面积;治疗后3个月采用GOS评分评估预后。结果 治疗后2周,两组血清IL-6、S100β、MBP、NSE和hs-CRP水平均明显下降（P<0.05）,但观察组下降幅度更明显（P<0.05）。治疗后2周,两组脑水肿面积和APACHE-Ⅱ评分均明显下降（P<0.05）,GCS评分明显上升（P<0.05）,观察组的变化幅度更明显（P<0.05）。治疗后3个月,观察组预后良好率（64.44%,29/45;GOS评分4~5分）明显高于对照组（46.67,1/45;P<0.05）。结论 依达拉奉联合鼠神经生长因子可以保护重症颅脑损伤患者的神经功能因子,降低脑水肿面积,缓解炎症,促进患者意识恢复。     

Vascular endothelial growth factor stimulates Schwann cell invasion and neovascularization of acellular nerve grafts

The aim of this study was to investigate the effects of vascular endothelial growth factor (VEGF) on regeneration of the rat sciatic nerve in vivo. To that end we used 10-mm long cell-free nerve grafts to bridge a gap in the sciatic nerve. The grafts were pretreated with either VEGF (50, 100 or 250 ng/ml), nerve growth factor (NGF, 100 ng/ml) or laminin (100 ng/ml) before implantation. Outgrowth of axons, Schwann cells, blood vessels and macrophages were studied 10 days post-implantation by the use of immunocytochemistry and histochemistry. Grafts pretreated with VEGF stimulated the outgrowth of Schwann cells and blood vessels but not axons. In such grafts, the Schwann cells also exhibited a dramatic change in morphology and became filled with large lipid-containing vacuoles. These cells also showed an intense immunoreactivity for the VEGF receptor flk-1. Neither pretreatment with laminin nor NGF affected the outgrowth of Schwann cells. However, NGF treatment increased the number of axons in the graft but was not able to counteract injury-induced downregulation of substance P in the dorsal root ganglia. The results show that local application of VEGF promotes at least two events, invasion of Schwann cells and neovascularization, which are important during nerve regeneration. The findings suggest that the effects of the pretreatment by the growth factors is local and limited to the graft, whereas central events like neuropeptide synthesis is not affected.     

脑缺血再灌注损伤中前体神经生长因子和成熟体神经生长因子及其受体的表达

实验观察脑缺血再灌注损伤中,前体神经生长因子和成熟体神经生长因子在缺血区皮质和非缺血区皮质的表达。结果发现在缺血区和非缺血区皮质中,前体神经生长因子表达在细胞外和胞浆,成熟体神经生长因子极低少量表达在细胞外。缺血侧皮质前体神经生长因子表达显著下降,至1d时达到最低值,成熟体神经生长因子在4h时表达增加,至3d时达到最低值,神经生长因子受体(p75NTR)在缺血后表达明显降低,至3d时达到峰值。证实脑缺血再灌注损伤的病理过程中：①前体神经生长因子是神经生长因子存在的主要形式。②脑缺血再灌注损伤影响了前体神经生长因子向成熟体神经生长因子的转化过程。③ 前体神经生长因子/p75NTR可能参与了缺血后的再灌注损伤。     

弥漫性脑损伤神经细胞凋亡及神经生长因子干预的实验研究

目的探讨弥漫性脑损伤后神经细胞凋亡及脑组织水肿情况及神经生长因子对此的干预作用。方法采用Marmarou脑损伤模型。将Spraque—Dawley鼠40只随机分成脑损伤组,神经生长因子治疗组和生理盐水对照组。治疗组分别于致伤后10min和60rain腹腔内注射神经生长因子（30mg／kg）,对照组注射等量生理盐水,于伤后24h、48h、72h和96h断头取脑,采用原位末端标记法检测凋亡细胞,对比各时段脑水肿和神经细胞的凋亡情况。结果神经细胞从伤后24h出现细胞凋亡,48～72h达高峰,治疗组与损伤组在24h,48h,72h和96h时脑组织含水量有显著性差异（P〈0．05）,对照组与损伤组含水量无显著性差异（P〉0．05）。结论神经生长因子对脑损伤性脑水肿及神经细胞凋亡有治疗作用。