Xiong Min, Chen Sen, Yu Hualong, Liu Zhigang, Zeng Yun, Li Feng
Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Department of Spinal Surgery, Dongfeng General Hospital, Hubei University of Medicine, Shiyan, 442008, China.
J Huazhong Univ Sci Technolog Med Sci. 2011 Oct;31(5):652. doi: 10.1007/s11596-011-0576-z. Epub 2011 Oct 25.
Recent research based on various animal models has shown the neuroprotective effects of erythropoietin (EPO). However, few studies have examined such effects of EPO in the clinic. In this study we enrolled patients with spinal cord ischemia-reperfusion (I-R) injury to investigate the clinical application of EPO and methylprednisolone (MP) for the neuroprotection against spinal cord I-R injury. Retrospective analysis of 63 cases of spinal cord I-R injury was performed. The Frankel neurological performance scale was used to evaluate the neurological function after spinal cord injury (SCI), including 12 cases of scale B, 30 cases of scale C, and 21 cases of scale D. These cases were divided into 2 groups: group A (27 cases) got treatment with both EPO and MP; group B (36 cases) got treatment with MP only. The neurological function of patients after treatment was evaluated by American Spinal Cord Injury Association (ASIA) index score, and activity of daily living (ADL) of the patients was also recorded. All patients got follow-up and the follow-up period ranged from 24 to 39 months (mean 26 months). There was no significance difference in neurological function between groups A and B before the treatment (P>0.05). However, the neurological function and ADL scores were significantly improved 1 week, 1 year or 2 years after the treatment compared to those before the treatment (P<0.05), and the improvement was more significant in group A than in group B (P<0.05). It is suggested that the clinical application of EPO and MP provides the neuroprotection against spinal cord I-R injury.
最近基于各种动物模型的研究表明了促红细胞生成素（EPO）的神经保护作用。然而，很少有研究在临床上检验EPO的这种作用。在本研究中，我们纳入了脊髓缺血再灌注（I-R）损伤患者，以研究EPO和甲基强的松龙（MP）对脊髓I-R损伤的神经保护临床应用。对63例脊髓I-R损伤病例进行了回顾性分析。采用Frankel神经功能量表评估脊髓损伤（SCI）后的神经功能，其中B级12例，C级30例，D级21例。这些病例分为2组：A组（27例）接受EPO和MP联合治疗；B组（36例）仅接受MP治疗。治疗后通过美国脊髓损伤协会（ASIA）指数评分评估患者的神经功能，并记录患者的日常生活活动能力（ADL）。所有患者均进行随访，随访时间为24至39个月（平均26个月）。治疗前A组和B组的神经功能无显著差异（P>0.05）。然而，与治疗前相比，治疗后1周、1年或2年时神经功能和ADL评分均显著改善（P<0.05），且A组的改善比B组更显著（P<0.05）。提示EPO和MP的临床应用对脊髓I-R损伤具有神经保护作用。
