促红细胞生成素治疗急性脊髓损伤的临床研究(1)
摘 要：目的 分析大剂量甲强龙联合促红细胞生成素治疗急性脊髓损伤患者的临床疗效。方法 选取2016年1月～2017年6月就诊于我院骨科的56例ASCI患者，采用控制主要因素的分层随机化分组法和简单随机分组法，将患者分为观察组与对照组，每组26例，观察组给予MP+EPO治疗，对照组给予MP治疗，并在患者收治入院时及治疗后1、6个月，严格按照ASIA评分标准，对患者的脊髓神经功能进行评定，并记录并发症情况。结果 与入院时相比，治疗后1月及6个月两组患者ASIA评分提高，差异有统计学意义(P<0.05)， 且观察组高于对照组，差异有统计学意义(P<0.05)。两组患者并发症比较，差异无统计学意义(P>0.05)。结论 MP冲击疗法联合EPO治疗ASCI比单用MP治疗效果更佳，EPO能有效促进ASCI患者的神經功能恢复。
关键词：急性脊髓损伤；甲强龙；冲击疗法；促红细胞生成素
中图分类号：R683.2 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.11.022
, 百拇医药
文章编号：1006-1959(2018)11-0070-03
Clinical Study of Erythropoietin in the Treatment of Acute Spinal Cord Injury
YANG Qiang，FANG Jian，WANG Hai-feng，LI Ge-wei，WANG Tao
(PLA Clinical College，Medical University of Anhui，Hefei 230000，Anhui，China)
Abstract：Objective To analyze the clinical efficacy of large dose methylprednisolone combined with erythropoietin in the treatment of acute spinal cord injury.Methods 56 patients with ASCI who were treated in our department of orthopaedics from January 2016 to June 2017 were selected.Stratified randomization and simple randomization methods were used to control the main factors.The patients were divided into observation group and control group.In the group of 26 patients，the observation group was given MP+EPO treatment， and the control group was given MP treatment.The spinal cord nerve function of the patient was assessed and the complications were recorded on the admission of the patient and 1，6 months after treatment，in strict accordance with the ASIA score.Results Compared with the time of admission，the ASIA scores of the two groups were increased at the 1st and 6th month after treatment，the difference was statistically significant(P<0.05)，and the observation group was higher than the control group，the difference was statistically significant(P<0.05).There was no significant difference in complications between the two groups(P>0.05).Conclusion MP shock therapy combined with EPO treatment of ASCI is more effective than MP alone，and EPO can effectively promote the recovery of neurological function in patients with ASCI.
, 百拇医药
Key words：Acute spinal cord injury；Methylprednisolone；Shock therapy；Erythropoietin
急性脊髓损伤(acute spinal cord injury，ASCI)作为目前脊柱外科发生率较高的一种创伤性疾病[1]。多为车祸、跌倒、暴力伤害等造成脊柱脱位、骨折所致[2]，因其高致残率和高致死率一直成为医学研究的热点。目前通过早期应用甲强龙冲击疗法联合手术减压治疗急性脊髓损伤在临床上已被成熟应用[3]， 但由于甲强龙(MP)苛刻的治疗时间窗及相应的并发症问题，限制了其在临床上的广泛应用，所以现如今研制一种与激素具有协同作用甚至可以取代激素的有效药物，一向是急性脊髓损伤药物治疗领域研究的热点[4]。近些年的实验研究结果显示，促红细胞生成素(erythropoietin，EPO)具有明显的营养神经及神经保护作用的功能，是一种新型的神经保护药物[5，6]。所以本课题通过对比MP联合EPO治疗方案与单用MP治疗急性脊髓损伤患者的临床疗效，探讨EPO对ASCI的治疗价值。, 百拇医药(杨强 方健 王海峰 李葛威 王涛)
关键词：急性脊髓损伤；甲强龙；冲击疗法；促红细胞生成素
中图分类号：R683.2 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.11.022
, 百拇医药
文章编号：1006-1959(2018)11-0070-03
Clinical Study of Erythropoietin in the Treatment of Acute Spinal Cord Injury
YANG Qiang，FANG Jian，WANG Hai-feng，LI Ge-wei，WANG Tao
(PLA Clinical College，Medical University of Anhui，Hefei 230000，Anhui，China)
Abstract：Objective To analyze the clinical efficacy of large dose methylprednisolone combined with erythropoietin in the treatment of acute spinal cord injury.Methods 56 patients with ASCI who were treated in our department of orthopaedics from January 2016 to June 2017 were selected.Stratified randomization and simple randomization methods were used to control the main factors.The patients were divided into observation group and control group.In the group of 26 patients，the observation group was given MP+EPO treatment， and the control group was given MP treatment.The spinal cord nerve function of the patient was assessed and the complications were recorded on the admission of the patient and 1，6 months after treatment，in strict accordance with the ASIA score.Results Compared with the time of admission，the ASIA scores of the two groups were increased at the 1st and 6th month after treatment，the difference was statistically significant(P<0.05)，and the observation group was higher than the control group，the difference was statistically significant(P<0.05).There was no significant difference in complications between the two groups(P>0.05).Conclusion MP shock therapy combined with EPO treatment of ASCI is more effective than MP alone，and EPO can effectively promote the recovery of neurological function in patients with ASCI.
, 百拇医药
Key words：Acute spinal cord injury；Methylprednisolone；Shock therapy；Erythropoietin
急性脊髓损伤(acute spinal cord injury，ASCI)作为目前脊柱外科发生率较高的一种创伤性疾病[1]。多为车祸、跌倒、暴力伤害等造成脊柱脱位、骨折所致[2]，因其高致残率和高致死率一直成为医学研究的热点。目前通过早期应用甲强龙冲击疗法联合手术减压治疗急性脊髓损伤在临床上已被成熟应用[3]， 但由于甲强龙(MP)苛刻的治疗时间窗及相应的并发症问题，限制了其在临床上的广泛应用，所以现如今研制一种与激素具有协同作用甚至可以取代激素的有效药物，一向是急性脊髓损伤药物治疗领域研究的热点[4]。近些年的实验研究结果显示，促红细胞生成素(erythropoietin，EPO)具有明显的营养神经及神经保护作用的功能，是一种新型的神经保护药物[5，6]。所以本课题通过对比MP联合EPO治疗方案与单用MP治疗急性脊髓损伤患者的临床疗效，探讨EPO对ASCI的治疗价值。, 百拇医药(杨强 方健 王海峰 李葛威 王涛)