摘要
目的探讨注射用鼠神经生长因子(mouse nerve growth factor,m NGF)治疗老年糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)的疗效和安全性。方法 120例老年DPN患者随机分为2组,年龄60～90岁,平均年龄(78.3±7.0)岁,每组60例。试验组年龄为60～90岁,平均年龄为(78.2±6.7岁),予30μg m NGF注射治疗;对照组年龄为62～88岁,平均年龄为(78.3±7.2)岁,予0.5 mg甲钴胺注射治疗,每周3次,疗程2个月。比较2组治疗后的总有效率;治疗前后的多伦多评分(Toronto clinical scoring system,TCSS)、密西根糖尿病周围神经评分(Michigan diabetic neuropathy score,MDNS);尺神经、正中神经及腓总神经的运动神经传导速度(motor nerve conduction velocity,MNCV)和感觉神经传导速度(sensory nerve conduction velocity,SNCV)的变化,观察有无不良反应发生。结果治疗后试验组总有效率优于对照组(85%vs 61.7%,P=0.011)。2组患者TCSS和MDNS评分均低于治疗前,且治疗后试验组改善幅度大于对照组,TCSS[(8.15±1.61) vs (9.27±1.36),P<0.05],MDNS[(18.78±4.10) vs (21.03±1.90),P<0.05]。2组尺神经、正中神经及腓总神经的MNCV和SNCV均较用药前改善,治疗后试验组腓总神经MNCV和SNCV的改善均优于对照组,MNCV[(45.09±3.14)m/s vs (43.63±4.27)m/s,P<0.05],SNCV[(47.11±4.46) m/s vs (43.50±2.91) m/s,P<0.05]。除注射部位疼痛外,2组均无严重不良反应。结论注射用m NGF对于改善老年DPN安全有效,较传统甲钴胺治疗存在优势。
Objective To explore the effect of mouse nerve growth factor(mNGF)on diabetic peripheral neuropathy(DPN)of the elderly and to evaluate the safety.Methods 120 elderly with DPN,aged from 60 to 90 years with the average of(78.3±7.0),were randomly divided into 2 groups:experiment group and control group,60 in each;the elderly in experiment group,aged from 60 to 90 with the average of(78.2±6.7),were given intramuscular injection of mNGF at the dose of 30μg 3 times a week while the elderly in control group,aged from 62 to 88 with the average of(78.3±7.2),were given intramuscular injection of mecobalamin at the dose of 0.5 mg 3 times a week,the courses for both groups lasted for 2 months;a comparative study between the 2 groups was made to the total effective rate,the scores of Toronto clinical scoring system(TCSS)and Michigan diabetic neuropathy score(MDNS)before and after treatment,the changes of motor nerve conduction velocity(MNCV)and sensory nerve conduction velocity(SNCV);observations were made to the occurrence of adverse reactions.Results The total effective rate in experiment group was superior to that in control group(85%vs 61.7%,P=0.011);the scores of TCSS and MDNS of the elderly in both groups after treatment were lower than those before treatment and the improvement in experiment group was bigger than that in control group[TCSS:(8.15±1.61)vs(9.27±1.36),P<0.05;MDNS:(18.78±4.10)vs(21.03±1.90),P<0.05];MNCV and SNCV in both groups were improved after treatment and the improvements in experiment group were much superior to those in control group[MNCV:(45.09±3.14)m/s vs(43.63±4.27)m/s,P<0.05;SNCV:(47.11±4.46)m/s vs(43.50±2.91)m/s,P<0.05];no serious adverse reactions were found in both groups except for the pain at injection site.Conclusions mNGF is safe and effective in treating DNP of the elderly,superior to traditional treatment with mecobalamin.
作者
王佳
胡予
罗蔓
吴琳
Wang Jia;Hu Yu;Luo Man;Wu lin(Department of Geriatrics,Zhongshan Hospital Affiliated to Fudan University,Shanghai,200032,P.R.China)
出处
《老年医学与保健》
CAS
2019年第1期55-58,82,共5页
Geriatrics & Health Care
关键词
老年
糖尿病周围神经病变
鼠神经生长因子
甲钴胺
elderly
diabetic peripheral neuropathy(DPN)
mouse nerve growth factor(mNGF)
mecobalamin
