鼠神经生长因子联合神经节苷脂治疗新生儿缺氧缺血性脑病的临床观察

发布时间：2018-01-23 22:59

本文关键词： 鼠神经生长因子神经节苷脂新生儿缺血缺氧性脑病炎症反应氧化应激　出处：《中国药房》2017年17期 　论文类型：期刊论文

【摘要】：目的:评价鼠神经生长因子联合神经节苷脂治疗新生儿缺氧缺血性脑病(HIE)的临床疗效及安全性。方法:选取2013年1月-2015年1月于我院儿科治疗的HIE患儿150例,按随机数字表法分为对照组和观察组,各75例。两组患儿均给予纠正低血压、降低颅内压等常规治疗;对照组患儿在常规治疗的基础上给予单唾液酸四己糖神经节苷脂钠注射液20 mg加入10%葡萄糖注射液30~50 m L中,ivgtt,qd;观察组患儿在对照组的基础上加用注射用鼠神经生长因子30μg加入注射用水2 m L中,im,qd。10 d为1个疗程,两组患儿均治疗2个疗程。比较两组患儿的临床疗效,治疗前后的新生儿神经行为测定(NBNA)评分、相关实验室检查指标[白细胞介素10(IL-10)、肿瘤坏死因子α(TNF-α)、超氧化物歧化酶(SOD)、神经元特异性烯醇化酶(NSE)、血管内皮生长因子(VEGF)]水平,以及不良反应和后遗症(随访至1岁)的发生情况。结果:观察组患儿的临床总有效率为86.7%,明显高于对照组的72.0%,差异有统计学意义(P0.05)。治疗前,两组患儿NBNA评分和实验室检查指标水平比较,差异均无统计学意义(P0.05)。治疗后第4、7、10天,两组患儿NBNA评分均较治疗前显著升高,且观察组评分显著高于对照组,差异均有统计学意义(P0.05);治疗后,两组患儿血清IL-10、TNF-α、NSE和VEGF水平均较治疗前显著降低,SOD水平显著升高,且观察组指标显著优于对照组,差异均有统计学意义(P0.05)。两组患儿在治疗期间均未见严重不良反应发生。观察组有64例患儿、对照组有60例患儿完成随访,观察组患儿总后遗症发生率为10.9%,显著低于对照组的25.0%,差异有统计学意义(P0.05)。结论:鼠神经生长因子联合神经节苷脂治疗新生儿HIE可有效减轻患儿脑组织炎症反应及氧化应激损伤,加速脑组织功能的修复,减少后遗症的发生,且安全性较高。
[Abstract]:Objective: to evaluate the effect of nerve growth factor (NGF) combined with ganglioside on neonatal hypoxic-ischemic encephalopathy (HIE). Methods: one hundred and fifty children with HIE were selected from January 2013 to January 2015 in our hospital. According to the method of random number table, the patients were divided into control group (75 cases) and observation group (75 cases). Both groups were given routine treatment such as correcting hypotension and lowering intracranial pressure. Children in the control group were treated with sodium sialate tetrahexose ganglioside injection 20 mg and 10% glucose injection 30 渭 m / L iv GTT QD on the basis of routine treatment. On the basis of the control group, the children in the observation group were treated with 30 渭 g nerve growth factor (NGF) for injection plus 2 mL of water for 10 days as a course of treatment. The two groups were treated for two courses of treatment. The clinical efficacy of the two groups was compared, the neonatal neurobehavioral test before and after treatment and the related laboratory examination indexes were compared. [Interleukin-10 (IL-10), tumor necrosis factor 伪 (TNF- 伪), superoxide dismutase (SOD), neuron-specific enolase (NSE). The level of vascular endothelial growth factor (VEGF) and the incidence of adverse reactions and sequelae (1 year old follow-up). Results: the total clinical effective rate of the observation group was 86.7%. The difference was statistically significant (P 0.05). Before treatment, the NBNA score and laboratory examination index were compared between the two groups. The NBNA scores of the two groups were significantly higher than those before treatment, and the scores of the observation group were significantly higher than those of the control group. The difference was statistically significant (P 0.05). After treatment, the serum levels of IL-10 TNF- 伪 NSE and VEGF in the two groups were significantly lower than those before treatment, and the indexes in the observation group were significantly better than those in the control group. The difference was statistically significant (P 0.05). No serious adverse reactions occurred in the two groups. There were 64 cases in the observation group and 60 cases in the control group. The incidence of total sequelae in the observation group was 10.9%, which was significantly lower than that in the control group (25.0%%). Conclusion: the combination of nerve growth factor and ganglioside can effectively reduce the inflammatory reaction and oxidative stress injury in neonatal HIE. Accelerate the repair of brain tissue function, reduce the occurrence of sequelae, and high safety.
【作者单位】：达州市中心医院儿科;
【分类号】：R742
【正文快照】： 新生儿缺氧缺血性脑病(Hypoxic-ischemia encepha-lopathy,HIE)是指由围产期各种原因引起的新生儿脑血流量降低或缺氧而导致的脑组织损伤。HIE作为新生儿窒息的主要并发症之一,具有发病率高、致死率高、致残率高等特点[1]。其中,脑组织原发性缺血缺氧损伤及再灌注损伤易诱发钙

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