陈曦

【摘要】 目的：探討神经生长因子联合奥拉西坦治疗高血压脑出血（HIH）的临床疗效。方法：选取2016年8月-2018年11月本院收治的HIH患者60例。按照随机数字表法将其分为观察组（n=45）和对照组（n=45）。对照组采用奥拉西坦治疗，观察组在对照组基础上加用神经生长因子，均治疗3周。比较两组神经功能评分（NIHSS）、生活自理能力评分（FIM）、血管内皮生长因子（VEGF）、Tau蛋白、白介素1β、胰岛素生长因子1（IGF1）、神经元特异性烯醇化酶（NSE）、血清P物质（SP）。结果：治疗后，观察组NIHSS评分低于对照组，FIM评分高于对照组，差异均有统计学意义（P<0.05）;治疗后，观察组VEGF、IGF1、SP水平均高于对照组，Tau蛋白、白介素1β、NSE水平均低于对照组，差异均有统计学意义（P<0.05）;两组均无明显不良反应发生。结论：神经生长因子联合奥拉西坦可改善HIH患者神经功能及日常生活活动能力，降低炎性因子分泌，促进脑功能恢复，值得临床推广。

【关键词】 高血压脑出血; 神经生长因子; 奥拉西坦; 联合治疗

Clinical Efficacy of Nerve Growth Factor Combined with Oxiracetam in Treatment of Hypertensive Intracerebral Hemorrhage/CHEN Xi.//Medical Innovation of China，2019，16（18）：0-044

【Abstract】 Objective：To investigate the clinical efficacy of Nerve Growth Factor combined with Oxiracetam in treatment of hypertensive intracerebral hemorrhage（HIH）.Method：A total of 60 patients with HIH admitted to our hospital from August 2016 to November 2018 were selected，according to random number table method，they were divided into observation group（n=45）and control group（n=45）.The control group was treated with Oxiracetam，while observation group was treated with Nerve Growth Factor on the basis of control group，they were treated for 3 weeks.The neurological function score（NIHSS），self-care ability score（FIM），vascular endothelial growth factor（VEGF），Tau protein，interleukin-1β，insulin growth factor-1（IGF1），neuron-specific enolase（NSE）and substance P（SP）in serum between two groups were compared.Result：After treatment，the NIHSS score of observation group was lower than that of control group，the FIM score was higher than that of control group，the differences were statistically significant（P<0.05）.After treatment，the levels of vascular endothelial growth factor，IGF1 and SP in observation group were higher than those of control group，the levels of Tau protein，interleukin-1βand NSE in observation group were lower than those of control group，the differences were statistically significant（P<0.05）.There were no obvious adverse reactions in the two groups.Conclusion：Nerve Growth Factor combined with Oxiracetam can improve the neurological function and activities of daily life of HIH patients，reduce the secretion of inflammatory factors，and promote the recovery of brain function，which is worthy of clinical promotion.

【Key words】 Hypertensive intracerebral hemorrhage; Nerve growth factor; Oxiracetam; Combined therapy

First-authors address：Jiamusi City Center Hospital，Jiamusi 154002，China

doi：10.3969/j.issn.1674-4985.2019.18.011

高血压脑出血（Hypertensive intracerebral hemorrhage，HIH）是临床常见的脑血管疾病，其中基底节区脑出血占70%[1]。HIH常发于中老年人群，具有高发病率、高死亡率、高复发率、高致残率等特征，同时临床病症以剧烈头痛、嗜睡、昏迷、躁动为主，严重影响患者的生活质量[2]。奥拉西坦是临床常用于治疗脑损伤、脑功能退化的神经保护性药物[3]。神经生长因子是一种可营养神经元和促进神经细胞再生、分化的调节因子[4]。本研究以90例HIH患者为研究对象，探讨神经生长因子联合奥拉西坦治疗该疾病的临床疗效，为临床实践提供参考。现报道如下。

1 资料与方法

1.1 一般资料 选取2016年8月-2018年11月本院收治的HIH患者60例。（1）纳入标准：经影像学及病理检查均符合高血压脑出血相关诊断标准[5];首次发病入院，出血量30～45 mL;心、肝、肺、肾功能无明显异常，无凝血功能障碍;无精神病史;未使用抗生素、糖皮质激素及免疫抑制剂等进行治疗;非药物、冠心病、外伤、肿瘤等导致的脑出血患者。……