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目的探究神经生长因子对重型颅脑损伤患者的治疗效果及血清基质金属蛋白酶-2(MMP-2)、血清神经元特异性烯醇化酶(NSE)水平影响研究,以为重型颅脑损伤患者的治疗提供参考。方法分析2014年6月—2015年12月91例在温州市人民医院接受治疗的重症颅脑损伤患者的临床资料,对照组(44例)给予常规对症治疗,观察组(47例)在常规治疗基础上增加鼠神经生长因子进行治疗。比较2组患者治疗前后血清MMP-2、NSE水平、GCS评分及不良发应发生率的差异。结果观察组患者治疗14 d后血清中MMP-2、NSE水平明显低于治疗前水平,观察组治疗14 d后MMP-2明显高于对照组,观察组治疗14 d后NSE水平低于对照组,差异均具有统计学意义(P<0.05);2组患者治疗14 d后GCS评分明显高于治疗前,观察组患者治疗14 d后GCS评分显著高于对照组,差异均具有统计学意义(P<0.05);治疗2周后,观察组患者中出现恶心、呕吐3例,头晕2例,下肢疼痛2例,不良反应率14.89%,对照组中恶心、呕吐2例,头晕1例,心率失常1例,不良反应率9.09%,2组患者不良反应发生率比较,差异不具有统计学意义(χ~2=0.720,P=0.396)。结论神经生长因子可明显降低血清中MMP-2、NSE水平,有助于患者神经功能的恢复,安全性较好。
Objective To investigate the effect of nerve growth factor (NGF) on the treatment of severe traumatic brain injury and on the levels of serum matrix metalloproteinase-2 (MMP-2) and serum neuron specific enolase (NSE) in patients with severe traumatic brain injury for reference. Methods The clinical data of 91 patients with severe craniocerebral injury treated in Wenzhou People’s Hospital from June 2014 to December 2015 were analyzed. The control group (44 patients) was given conventional symptomatic treatment and the observation group (47 patients) received routine treatment Based on the increase of rat nerve growth factor for treatment. The difference of serum MMP-2, NSE level, GCS score and incidence of adverse reactions between the two groups before and after treatment were compared. Results The levels of serum MMP-2 and NSE in observation group were significantly lower than those before treatment after 14 days of treatment. The MMP-2 level in observation group was significantly higher than that in control group on the 14th day after treatment, and the NSE level in observation group was lower than that in control group (P <0.05). The GCS scores of the two groups were significantly higher than those before treatment after 14 days of treatment, the GCS scores of the observation group were significantly higher than those of the control group after 14 days of treatment, the differences were statistically significant (P < P <0.05). After 2 weeks of treatment, nausea and vomiting occurred in 3 cases in the observation group, 2 cases of dizziness, 2 cases of lower extremity pain and 14.89% of adverse reactions. In the control group, nausea and vomiting in 2 cases, dizziness in 1 case, 1 case was abnormal and the adverse reaction rate was 9.09%. There was no significant difference between the two groups in the incidence of adverse reactions (χ ~ 2 = 0.720, P = 0.396). Conclusion Nerve growth factor can significantly reduce the levels of MMP-2 and NSE in serum and help to restore the neurological function of patients with better safety.