鼠神经生长因子治疗急性脑梗死后吞咽障碍的疗效
| 作者: |
1高凤岩,
2尹惠丽,
3于丽,
4陈永庆,
5徐丽丽
1 廊坊市第四人民医院神经内科，河北 廊坊 065700 2 廊坊市第四人民医院内二科，河北 廊坊 065700 3 廊坊市第四人民医院眼科，河北 廊坊 065700 4 廊坊市第四人民医院药剂科，河北 廊坊 065700 5 廊坊市第四人民医院内一科，河北 廊坊 065700 |
| 通讯: |
高凤岩
Email: gaofy1969@163.com |
| DOI: | 10.3978/j.issn.2095-6959.2018.06.017 |
| 基金: | 廊坊市科学技术研究与发展计划 (2017013078) |
摘要
目的：探讨鼠神经生长因子(mouse nerve growth factor，mNGF)对急性脑梗死后吞咽障碍的疗效。方法：将72例急性脑梗死后吞咽障碍患者随机分为对照组与mNGF组，每组各36例。两组均接受常规药物治疗、吞咽功能训练和电刺激治疗，mNGF组另加mNGF肌肉注射治疗。采用石氏计分法评估两组临床疗效。观察比较两组治疗前后国立卫生研究院卒中量表(National Institutes of Health Stroke Scale，NIHSS)评分、神经元特异性烯醇化酶(neuron-specific enolase，NSE)血清水平。分别采用洼田饮水试验、标准吞咽功能评价量表(Standardized Swallowing Assessment，SSA)、吞咽障碍特异性生活质量量表(Swallowing Related Quality of Life，SWAL-QOL)评定两组患者吞咽障碍程度、吞咽功能及生活质量。结果：治疗6周后，mNGF组总有效率为88.9%，对照组总有效率为69.4%，两组疗效比较，差异有统计学意义(P<0.05)；NIHSS评分及血清NSE水平较治疗前均显著降低(P<0.05)，但mNGF组下降幅度显著大于对照组(P<0.05)。与治疗前相比，两组患者治疗6周后洼田饮水试验评级、SSA评分和SWAL -QOL评分均有明显改善(P<0.05)，但mNGF组改善程度大于对照组(P<0.05)；mNGF组治疗后侧支循环开放率为80.6%(29/36)，明显高于对照组的58.3%(21/36)，两组侧支循环开放率差异有统计学意义(P<0.05)。结论：mNGF治疗可有效改善急性脑梗死后吞咽障碍。
关键词：
鼠神经生长因子；急性脑梗死；吞咽障碍；生活质量
Effect of mouse nerve growth factor on dysphagia in patients after acute cerebral infarction
CorrespondingAuthor: GAO Fengyan Email: gaofy1969@163.com
DOI: 10.3978/j.issn.2095-6959.2018.06.017
Foundation: This work was supported by the Langfang Science and Technology Research and Development Project, China (2017013078)
Abstract
Objective: To investigate the influence of mouse nerve growth factor (mNGF) on dysphagia in patients with acute cerebral infarction. Methods: A total of 72 patients with dysphagia after acute cerebral infarction were divided randomly into a control group (n=36) and a mNGF group (n=36). The patients in the two groups were treated with routine drugs, swallowing function training and electrical stimulation, the patients in the mNGF group were added to intramuscular injection of mNGF. The clinical curative effects were evaluated by Shi’s scoring method after treatment in the two groups. National Institutes of Health Stroke Scale (NIHSS) scores and serum levels of neuron-specific enolase (NSE) were compared before and after the treatment in the two groups. Degree of impaired swallowing, swallowing function and quality of life were assessed by Kubota drinking water test, Standardized Swallowing Assessment (SSA) and Swallowing Related Quality of Life (SWAL-QOL) before and after the treatment in the two groups. Results: The total effective rate was 88.9% in the mNGF group and 69.4% in the control group for 6 weeks after the treatment, the difference was statistically significant (P<0.05). Compared with those before the treatment, NIHSS scores and serum NSE levels reduced significantly for 6 weeks after the treatment (P<0.05), but the decrease amplitudes in the mNGF group were greater significantly than those in control group (P<0.05). Compared with those before the treatment, the scores of Kubota drinking water test, SSA and SWAL-QOL improved obviously for 6 weeks after treatment in the two groups (P<0.05); the improved degrees in the mNGF group were higher than those in the control group (P<0.05). The opening rate of collateral circulation in the mNGF group was 80.6% (29/36), significantly higher than 58.3% (21/36) in the control group, and the difference was statistically significant (P<0.05). Conclusion: Intramuscular injection of mNGF combined with low-frequency electric stimulation can improve effectively impaired swallowing and quality of life in acute cerebral infarction patients with dysphagia.
Keywords：
mouse nerve growth factor; acute cerebral infarction; dysphagia; quality of life