目的 探討注射用鼠神經(jīng)生長因子（NGF）對急性腦梗死患者血清神經(jīng)元特異性烯醇化酶（NSE）和一氧化氮合酶（NOS）活性的影響。方法 選擇2015年3月—2017年7月住院治療的急性腦梗死患者92例，隨機分為常規(guī)組（n=46）和mNGF組（n=46）。常規(guī)組按常規(guī)方法給予抗血小板聚集、降顱壓、降脂穩(wěn)定斑塊、控制血壓血糖、抗感染、維持水電平衡等，根據(jù)患者個體情況應用脫水劑及加強營養(yǎng)；mNGF組在常規(guī)治療基礎上加用鼠NGF肌肉注射治療，30 μg/次，1次/d，共治療28 d。對比兩組治療后總有效率，觀察并比較兩組治療前后NIHSS評分、Barthel指數(shù)及血清NSE、一氧化氮（NO）、NOS水平。結果 mNGF組治療后總有效率（89.13%）明顯高于常規(guī)組（67.39%），兩組治療后總有效率比較差異有統(tǒng)計學意義（P<0.05）。與治療前比較，兩組治療28 d后NIHSS評分明顯下降（P<0.05）、Barthel指數(shù)明顯增高，同組治療前后比較差異均有統(tǒng)計學意義（P<0.05）；但mNGF組變化程度大于常規(guī)組，組間差異有統(tǒng)計學意義（P<0.05）。兩組治療前NSE、NO及NOS水平無統(tǒng)計學差異；兩組治療14 d、28 d后NSE、NO及NOS水平明顯下降，同組治療前后比較差異有統(tǒng)計學意義（P<0.05）；但mNGF組下降幅度明顯大于常規(guī)組，組間差異有統(tǒng)計學意義（P<0.05）。結論 注射用鼠NGF治療能有效降低急性腦梗死患者血清NSE和NOS活性，從而發(fā)揮對缺血腦損傷的保護作用，促進神經(jīng)功能的恢復。

Objective To observe the influence of mouse nerve growth factor injection on neuron-specific enolase (NSE), nitric oxide synthase (NOS) activity in patients with acute cerebral infarction. Methods 92 cases of patients with acute cerebral infarction were chosen as the research objects from March 2015 to July 2017 in our hospital. All patients were randomly divided into routine group (n=46) and mNGF group (n=46). Routine group was treated with conventional methods such as anti-platelet aggregation, reduction of cranial pressure, lipid-lowering and stabilize the plaques, controlling blood pressure and blood glucose, anti-infection, maintenance of water and electrolyte balance, etc, applying dehydrating agents and strengthening nutrition according to the patient's individual situation, mNGF group was added to mNGF injection (30 μg/times, 1 times/d) on the basis of conventional treatment. Two groups were treated for 28 d. Total efficiency after treatment were compared between two groups. NIHSS score, Barthel index and serum NSE, nitric oxide (NO), NOS levels before and after treatment were observed and compared in two groups. Results The total effective rate was 89.13% after treatment in mNGF group, and was significantly higher than 67.39% of routine group, the difference was statistically significant (P < 0.05). Compared with those before treatment, the NIHSS scores of the two groups were significantly lower (P < 0.05) and the Barthel indexes significantly increased (P < 0.05), but the change of mNGF group was greater than those of routine group (P < 0.05). There was no statistically significant difference between two groups in NSE, NO and NOS. The levels of NSE, NO and NOS in two groups were significantly decreased after treatment of 14 d and 28 d (P < 0.05), but the decrease of mNGF group was significantly greater than those of routine group (P < 0.05). Conclusion mNGF injection can effectively reduce serum NSE and NOS activity in patients with acute cerebral infarction, thus play a role in the protection of ischemic brain injury and promote the recovery of nervous function.