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.

Clinical observation on nerve growth factor in the treatment of severe craniocerebral trauma

Objective To investigate the influence of nerve growth factor (NGF) on the level of plasma creatine kinase BB (CK-BB) and its clinical effect in patients with severe craniocerebral trauma. Methods Eighty patients with severe craniocerebral trauma (GCS≤8) were randomly assigned to NGF-treated (n=40) and control (n=40) groups. Conventional therapy was performed on these patients and NGF was added into the NGF-treated group. The level of plasma CK-BB in these patients was measured; the clinical prognosis of the patients was evaluated based on the GOS scores 6 months after severe craniocerebral trauma; the condition of regained consciousness was compared between the 2 groups. Results Plasma CK-BB in the NGF-treated group was significantly lower than that in the control group (P<0.05); the recovery rate in the NGF-treated group (24/40) was significantly higher than that in the control group (11/40); the consciousness regained within i month was found in 32 patients in the NGF-treated group but only 18 of that was noted in the control group (P<0.05); NGF-treated group (12.43±6.25) showed a significantly shorter time that consciousness was regained as compared with the control group (15.96±7.58). Conclusion NGF can decrease the level of plasma CK-BB, shorten coma time and improve life quality in patients with severe craniocerebral trauma. Application ofNGF, a safe and effective treatment method, provides a new potential therapeutic strategy for patients with CNS injury.