鼠神经生长因子在格林-巴利综合征治疗中促神经修复的作用

目的:探讨鼠神经生长因子在格林-巴利综合征治疗中促周围神经修复的作用。方法:格林-巴利综合征脱髓鞘组98例,分为脱髓鞘治疗组(A)50例及脱髓鞘对照组(B)48例;格林-巴利综合征混合型组88例,分为混合型治疗组(C)45例,混合型对照组(D)43例。格林-巴利综合征单纯轴索病变组39例,分为轴索型治疗组(E)21例,轴索型对照组(F)18例。A,C,E组常规应用静脉注射丙种球蛋白0．4 g·kg~(-1)·d~(-1),连用5 d等治疗并加用鼠神经生长因子,B,D,F组仅常规应用静脉注射丙种球蛋白0．4g·kg~(-1)·d~(-1),连用5 d等治疗,疗程结束后做神经功能评价及肌电图评价。结果:脱髓鞘组中A组的明显好转、痊愈率及神经传导速度恢复明显高于B组,P＜0．05;混合型组中C组在明显好转、痊愈率及神经传导速度与波幅恢复较D组明显提高,P＜0．05;轴索型组中E,F组在临床明显好转及痊愈率无显著差异,P＞0．05,但波幅恢复E较F组明显提高,P＜0．05。结论:鼠神经生长因子对格林-巴利综合征周围神经髓鞘的再生和轴索的恢复有显著疗效。

Repair role of mouse nerve growth factor to peripheral nerve in Giullain-Barre syndrome

AIM:To study the repair role of mouse nerve growth factor(mNGF)in peripheral nerve for Guillain-Barre syndrome(GBS).METHODS:GBS demyelination group 98 patients were divided into treatment group A 50 patients and controlled group B 48 patients;GBS mixed group 88 patients were divided into treatment group C 45 patients and controlled group D 43 patients;GBS axonal degeneration group 39 patients were divided into treatment group E 21 patients and controlled group F 18 patients.A,C,E groups were treated with intravenous immunoglobulin 0.4 g·kg~(-1)·d~(-1)for 5 d and mNGF for 2 mo individually;B,D,F groups were only treated with intravenous immunoglobulin 0.4 g·kg~(-1)·d~(-1)for 5 d individually.Patients' nerve function and electromyogram(EMG)were evaluated at the beginning and end of the treatment.RESULTS: Recovery rate,full recovery rate and motor nerve conduction velocity(NCV)in A group were more better than those in B group,P＜0.05.Recovery rate,full recovery rate,motor NCV and motor nerve wave range in C group were greatly better than those in D group,P＜0.05.Clinical recovery rates and full recovery rates showed no obvious difference between E and F group,P＞0.05,but motor nerve wave range in E group demonstrated obviously higher than that in F group,P＜0.05.CONCLUSION:mNGF possesses significant effect for the recovery of demyelination and axonal degeneration in GBS.