鼠神经生长因子联合腺苷钴胺对糖尿病周围神经病变患者血清ESM-1 ET-1 MBP Hcy的影响研究

摘要

目的:探讨鼠神经生长因子联合腺苷钴胺对糖尿病周围神经病变患者临床疗效以及对血清内皮细胞特异性分子-1(ESM-1)、内皮素-1(ET-1)、髓鞘碱性蛋白(MBP)和同型半胱氨酸(Hcy)水平的影响.方法:选择我院2016年4月至2017年7月收治的糖尿病周围神经病变患者进行研究,随机分为对照组和观察组,各45例.两组患者检查完毕后给予注射用鼠神经生长因子进行治疗,观察组在此基础上增加腺苷钴胺注射液.动态监测分析两组患者治疗前后的临床疗效,TSS(神经病变自觉症状问卷)、TCSS(多伦多临床神经病变评分)和VAS(视觉模拟评分)评分,观察分析两组患者的血清ESM-1、ET-1、MBP、Hcy水平以及神经传导速度.结果:治疗后,观察组总有效率86.67％(39/45)优于对照组68.89％(31/45)(P<0.05);观察组TSS、TCSS、VAS评分均低于对照组(P<0.05);观察组血清ESM-1、ET-1、MBP、Hcy水平均低于对照组(P<0.05);观察组胫总神经、正中神经的MNCV、SNCV明显增快,且传导速度优于对照组(P<0.05).结论:鼠神经生长因子联合腺苷钴胺在提高临床疗效以及神经传导速度的同时降低血清ESM-1、ET-1、MBP、Hcy水平和TSS、TCSS、VAS评分.%Objective:To investigate the effects of mouse nerve growth factor combined with adenosine cobalt on diabetic peripheral neuropathy in patients with clinical efficacy and serum on endothelial cell specific molecule -1 (ESM-1), endothelin -1 (ET-1), myelin basic protein (MBP) and homocysteine (Hcy) lev-el of influence. Methods:90 patients of diabetic peripheral neuropathy sdmitted in our hospital from April 2016 to July 2017 were selected as research objects. The two groups were treated with Mouse Nerve Growth Factor for Injection after their examination. On this basis, the observation group added adenosine cobalamin in-jection. Dynamic monitoring and analysis of clinical efficacy of two groups of patients before and after treat-ment, TSS ( neuropathy symptoms questionnaire) , TCSS ( Toronto clinical scoring system) and VAS ( visual analogue scale) score, observation of the two groups of patients with serum ESM-1, ET-1, MBP, Hcy level and nerve conduction velocity. Results:After treatment, the total effective rate of the observation group was 86.67％ (39/45) superior to that of the control group (68.89％ (31/45) (P < 0.05). The scores of TSS, TCSS and VAS in the observation group were all lower than those in the control group ( P < 0.05) . The serum levels of ESM-1, ET-1, MBP and Hcy in the observation group were lower than those in the control group ( P< 0.05) . The MNCV and SNCV of the tibial nerve and median nerve in the observation group increased signif-icantly, and the conduction velocity was better than that of the control group (P < 0.05). Conclusion:The combination of mouse nerve growth factor and adenosine cobalamin can improve the clinical efficacy and nerve conduction velocity, and decrease serum ESM-1, ET-1, MBP and Hcy levels, as well as TSS, TCSS and VAS scores.