Abstrakt

The therapeutic effect of combined therapy of hemopoietin and methylprednisolone in treatment of spinal cord ischemia-reperfusion injury of patient with cervical spondylotic myelopathy and its influence to the level of serum IL-1β, IL-1Ra and IL- 8

Qin Hao, Juan Shen & Lin Zhao

Purpose: To study thetherapeutic effect of combined therapy of hemopoietin and methylprednisolone in treatment of spinal cord ischemia-reperfusion injury and explore the its influence to the level of IL-1β, IL-1Ra and IL-8.

Method: 80 patients who had been accepted for cervical spondylotic myelopathy in our hospital during March 2014 to September 2017 were selected as research objects. They were randomly divided into control group and observation group, each containing 40 patients. Both groups of patients were subjected to anterior cervical discectomy and fusion internal fixation. However, the difference was that the control group was subjected to Rapid intravenous injection of 30 mg/kg methylprednisolone 30 min prior to spinal cord decompression, while the observation group was subjected to intravenous injection of both 30mg/kg methylprednisolone and 3000U/kg hemopoietin 30 min before spinal cord decompression. The neurological function of both groups of patients before treatment and 3 months after treatment was evaluated using JOA score (Japanese orthopeadic association score) and spinal cord function rating method (40-point rating method). ELISA was carried out to measure the level of S-100β, neurone specific enolase (NSE), IL-1β, IL-1Ra, IL-8 of two groups of patients; The life quality of patients in both groups 3 months after treatment was evaluated using WHOQOL-100.

Results: After 3 months of treatment, the JOA score and score of 40-point rating method for observation group was (18.33 ± 2.71) point and (39.12 ± 3.97) point, respectively, which were significantly higher than that (P=0.025,0.019) of control group; the level of S-100β and NSE in observation group was (0.08 ± 0.02)g/L and (9.51±0.45)g/L, respectively, which were significantly higher than values (P=0.031,0.022) of control group; the level of IL-1β and IL-8 in observation group was (21.73 ± 3.55)ng/L and (356.97 ± 32.26)ng/L, respectively, both of which were lower than the values (P=0.016,0.018) of control group; while the level of L-1Ra in observation was (21.63 ± 1.14)ng/L, which was higher than that (P=0.021)of control group; the WHOQOL-100 scores in physiology, psychology, independence, social relation, environment, spirit and overall life quality of observation group were all higher than that of control group, indicating the intergroup difference was of statistical significance (all P<0.001).

Conclusion: The combined therapy of hemopoietin and methylprednisolone achieved significant therapeutic effect in treatment of spinal cord ischemia-reperfusion injury. Moreover, this combined therapy had effective function in reducing S-100β and NSE, inhibiting IL-1β, increasing IL-8 and IL-1Ra, and thus realized protection of spinal cord nerve function and improved the life quality of patients. The combined therapy of hemopoietin and methylprednisolone is worth of being promoted in clinics.