神经节苷脂联合亚低温治疗新生儿窒息并发缺氧缺血性脑病的疗效观察
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摘要
目的探究新生儿窒息并发缺氧缺血性脑病(HIE)行神经节苷脂联合亚低温治疗的效果。方法选取2014年2月至2016年10月南阳南石医院收治的新生儿窒息并发HIE患儿72例,按随机数表法分为对照组(36例,亚低温治疗)、研究组(36例,神经节苷脂联合亚低温治疗)。比较两组患儿临床疗效、血浆超氧化物歧化酶(SOD)、亚硝酸盐(NO_2~-)、血浆硝基酪氨酸(NT)水平、新生儿行为神经评分(NBNA)、不良反应及后遗症发生情况。结果研究组患儿临床治疗总有效率(97. 22%)高于对照组(72. 22%),差异有统计学意义(P <0. 05)。治疗后,研究组患儿SOD水平高于对照组,NO_2~-、NT水平低于对照组,NBNA评分高于对照组,差异有统计学意义(P <0. 05)。两组患儿治疗期间均无严重不良反应发生,治疗后随访12个月后遗症发生率比较,研究组(8. 33%)低于对照组(19. 44%),但差异无统计学意义(P> 0. 05)。结论神经节苷脂联合亚低温治疗可促进新生儿窒息并发HIE患儿行为神经功能的恢复,提高治疗效果。
Objective To explore the clinical effect of ganglioside combined with mild hypothermia on neonatal asphyxia complicated with hypoxic ischemic encephalopathy( HIE) in neonates. Methods Seventy-two cases of neonatal asphyxia complicated with HIE were selected from Feb 2014 to Oct 2016 in Nanyang Nanshi Hospital. According to the random number table method,they were divided into control group( 36 cases,mild hypothermia treatment) and study group( 36 cases,ganglioside combined with mild hypothermia treatment). The clinical efficacy,plasma superoxide dismutase( SOD),nitrite(NO_2~-),plasma nitrotyrosine( NT) level,neonatal behavioral neurological score( NBNA),adverse reactions and sequelae were all compared between two groups. Results The total effective rate of clinical treatment in study group( 97. 22%) was higher than that in control group( 72. 22%),and the difference was statistically significant( P < 0. 05). After treatment,the SOD level of study group was higher than that of control group,the NO_2~- and NT levels were lower than those of control group,and the NBNA score was higher thanthat of control group,and the differences were statistically significant( P < 0. 05). There were no serious adverse reactions in two groups during the treatment. The incidence of sequelae was 12 months after treatment. The study group( 8. 33%)was lower than the control group( 19. 44%),but the difference was not statistically significant( P > 0. 05). Conclusion Ganglioside combined with mild hypothermia therapy can significantly improve the behavioral neurological function of neonates with asphyxia complicated with HIE and improve the therapeutic effect.
Objective To explore the clinical effect of ganglioside combined with mild hypothermia on neonatal asphyxia complicated with hypoxic ischemic encephalopathy( HIE) in neonates. Methods Seventy-two cases of neonatal asphyxia complicated with HIE were selected from Feb 2014 to Oct 2016 in Nanyang Nanshi Hospital. According to the random number table method,they were divided into control group( 36 cases,mild hypothermia treatment) and study group( 36 cases,ganglioside combined with mild hypothermia treatment). The clinical efficacy,plasma superoxide dismutase( SOD),nitrite(NO_2~-),plasma nitrotyrosine( NT) level,neonatal behavioral neurological score( NBNA),adverse reactions and sequelae were all compared between two groups. Results The total effective rate of clinical treatment in study group( 97. 22%) was higher than that in control group( 72. 22%),and the difference was statistically significant( P < 0. 05). After treatment,the SOD level of study group was higher than that of control group,the NO_2~- and NT levels were lower than those of control group,and the NBNA score was higher thanthat of control group,and the differences were statistically significant( P < 0. 05). There were no serious adverse reactions in two groups during the treatment. The incidence of sequelae was 12 months after treatment. The study group( 8. 33%)was lower than the control group( 19. 44%),but the difference was not statistically significant( P > 0. 05). Conclusion Ganglioside combined with mild hypothermia therapy can significantly improve the behavioral neurological function of neonates with asphyxia complicated with HIE and improve the therapeutic effect.
引文
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[12]祁钰.中西药物联用治疗帕金森病52例[J].西部中医药,2016,29(8):108-110.
[13]齐夏.苦碟子注射液联合神经节苷脂治疗急性脑梗死的临床研究[J].西部中医药,2016,29(5):87-89.
[14]陈茜娜,徐棉,林振浪,等.单唾液酸四己糖神经节苷脂联合头部亚低温治疗对新生儿缺氧缺血性脑病的疗效观察[J].浙江医学,2017,39(1):40-42.
[15]王金兰,乐婷,闫莹莹,等.阿托伐他汀对局灶性脑缺血大鼠脑组织中自噬及血管新生的影响[J].郑州大学学报(医学版),2016,51(1):114-118.
[16]王玉梅.神经节苷脂联合头部亚低温治疗新生儿缺氧缺血性脑病[J].中国实用神经疾病杂志,2015,18(9):45-47.
[2]欧明明,任太亮,张燕,等.亚低温联合药物治疗新生儿缺氧缺血性脑病的研究进展[J].安徽医学,2015,36(12):1558-1561.
[3] WANG B,ARMSTRONG J S,REYES M,et al. White matter apoptosis is increased by delayed hypothermia and rewarming in a neonatal piglet model of hypoxic ischemic encephalopathy[J]. Neuroscience,2016,316(1):296-310.
[4]孙晓华,谢颖,闫慧娟,等.新生儿缺氧缺血性脑病亚低温治疗中预见性临床护理效果观察[J].河北医学,2016,22(6):1031-1033.
[5]李亚梅,于若琳,郭海娜,等.头部亚低温技术治疗新生儿缺氧缺血性脑病疗效观察[J].现代中西医结合杂志,2015,24(8):842-844.
[6]崔彦存,李洋,姚丽丽.阿莫西林钠克拉维酸钾联合头部亚低温治疗新生儿缺血缺氧性脑病伴肺部感染的临床观察[J].中国药房,2016,27(20):2798-2801.
[7]石超.头部亚低温治疗新生儿HIE对血浆ICAM-1caspase-3水平及NBNA评分的影响研究[J].河北医学,2017,23(8):1319-1323.
[8] REINBOTH B S,KOSTER C,ABBERGER H,et al. Endogenous hypothermic response to hypoxia reduces brain injury:implications for modeling hypoxic-ischemic encephalopathy and therapeutic hypothermia in neonatal mice[J]. Exp Neurol,2016,283(Pt A):264-275.
[9]张梅梅,闫方方,蒋超,等.重组人促红细胞生成素对短暂性缺氧新生大鼠的神经保护作用[J].郑州大学学报(医学版),2016,51(3):382-386.
[10] GOULDING R M,STEVENSON N J,MURRAY D M,et al.Heart rate variability in hypoxic ischemic encephalopathy:correlation with EEG grade and 2-y neurodevelopmental outcome[J]. Pediatr Res,2015,77(5):681-687.
[11]胡玉莲,徐淑玲,邓彩艳,等.头部亚低温联合神经节苷脂治疗新生儿缺氧缺血性脑病的疗效[J].中国实用神经疾病杂志,2017,20(4):102-104.
[12]祁钰.中西药物联用治疗帕金森病52例[J].西部中医药,2016,29(8):108-110.
[13]齐夏.苦碟子注射液联合神经节苷脂治疗急性脑梗死的临床研究[J].西部中医药,2016,29(5):87-89.
[14]陈茜娜,徐棉,林振浪,等.单唾液酸四己糖神经节苷脂联合头部亚低温治疗对新生儿缺氧缺血性脑病的疗效观察[J].浙江医学,2017,39(1):40-42.
[15]王金兰,乐婷,闫莹莹,等.阿托伐他汀对局灶性脑缺血大鼠脑组织中自噬及血管新生的影响[J].郑州大学学报(医学版),2016,51(1):114-118.
[16]王玉梅.神经节苷脂联合头部亚低温治疗新生儿缺氧缺血性脑病[J].中国实用神经疾病杂志,2015,18(9):45-47.