神经节苷脂联合亚低温治疗新生儿缺氧缺血性脑病的疗效及对患儿行为智能发育影响

doi:10.3969/j.issn.1006-6233.2023.12.017

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1221 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要 目的: 探究神经节苷脂联合亚低温治疗新生儿缺氧缺血性脑病(HIE)的疗效及对患儿行为、智能发育影响。方法: 选取2018年1月至2022年12月本院收治的148例HIE患者,随机分为实验组和对照组,74例/组。对照组接受神经节苷脂治疗,实验组在此基础上联合亚低温进行治疗,观察两组治疗后疗效、新生儿行为神经评分(NBNA)、临床表现恢复时间、智能发育商数(DQ)评分以及治疗前后神经损伤标志物[ S100β蛋白、神经元特异性烯醇化酶(NSE)和髓磷脂碱性蛋白(MBP)]和血清炎性因子[白细胞介素-8(IL-8)、超敏C反应蛋白(hs-CRP)和肿瘤坏死因子-α(TNF-α)]水平。结果: 治疗后,实验组治疗总有效率高于对照组(P<0.05);实验组各时间点NABA得分均明显高于对照组(P<0.05);实验组各临床表现恢复时间明显短于对照组(P<0.05);实验组智能发育各指标得分较治疗前升高值大于对照组(P<0.05);实验组S100β蛋白、NSE和MBP水平较治疗前降低值大于对照组(P<0.05);实验组IL-8、hs-CRP和TNF-α水平较治疗前降低值大于对照组(P<0.05)。结论: 将神经节苷脂和亚低温联合应用于HIE的临床治疗中,其疗效良好,能改善患儿的行为神经功能和智能发育水平,缩短原始反射、吮吸等临床表现的恢复时间,降低患儿体内炎性因子和神经损伤标志物的水平。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	杨夏
	武育菁

关键词 ：神经节苷脂, 亚低温, 新生儿缺氧缺血性脑病, 疗效, 患儿行为, 智能发育

Abstract：Objective: To investigate the efficacy of ganglioside combined with hypothermia in the treatment of neonatal hypoxic-ischemic encephalopathy (HIE) and its impact on the behavior and intellectual development of affected children. Methods: A total of 148 patients with HIE admitted to the hospital were enrolled and randomly divided into experimental group and control group between January 2018 and December 2022, 74 cases in each group. The control group was treated with ganglioside, while experimental group was additionally treated with mild hypothermia. The curative effect after treatment, score of neonatal behavioral neurological assessment (NBNA), recovery time of clinical manifestations, score of intelligent development quotient (DQ), levels of nerve injury markers [S100β protein, neuron-specific enolase (NSE), myelin basic protein (MBP)] and serum inflammatory factors [interleukin-8 (IL-8), hypersensitive C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α)] in the two groups were observed before and after treatment. Results: After treatment, the total effective rate in the experimental group was higher than that in the control group (P<0.05). The NBNA scores at various time points in the experimental group were significantly higher than those in the control group (P<0.05). The clinical recovery times in the experimental group were significantly shorter than those in the control group (P<0.05). The DQ scores in the experimental group were higher than the pre-treatment values and greater than those in the control group (P<0.05). The levels of S100β protein, NSE, and MBP in the experimental group were lower than the pre-treatment values and lower than those in the control group (P<0.05). The levels of IL-8, hs-CRP, and TNF-α in the experimental group were lower than the pre-treatment values and lower than those in the control group (P<0.05). Conclusion: The combined application of ganglioside and hypothermia in the clinical treatment of HIE is effective, improving the behavioral and neural functions as well as the intellectual development of affected children. It shortens the recovery time of clinical manifestations such as primitive reflexes and sucking, and reduces the levels of inflammatory factors and neuroinjury markers in children.

Key words： Ganglioside Mild hypothermia Neonatal hypoxic-ischemic encephalopathy Curative effect Child's behavior Intelligent development

基金资助:江苏省卫生健康委科研项目,(编号:LGY2018048)

通讯作者: 武育菁

引用本文:

杨夏, 武育菁. 神经节苷脂联合亚低温治疗新生儿缺氧缺血性脑病的疗效及对患儿行为智能发育影响[J]. 河北医学, 2023, 29(12): 2028-2033.
YANG Xia, WU Yujing. Efficacy of Ganglioside Combined with Hypothermia in the Treatment of Neonatal Hypoxic-Ischemic Encephalopathy and Its Impact on Behavioral and Intellectual Development in Children. HeBei Med, 2023, 29(12): 2028-2033.

链接本文:

http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2023.12.017 或 http://www.hbyxzzs.cn/CN/Y2023/V29/I12/2028

[1] Meder U,Cseko AJ,Szakacs L,et al.Longitudinal analysis of amplitude-integrated electroencephalography for outcome prediction in hypoxic-ischemic encephalopathy[J].Pediatr,2022,46(7):19-25.
[2] 杨传忠,朱小瑜.亚低温治疗与脑保护[J].中华实用儿科临床杂志,2014,29(2):86-89.
[3] 中华医学会儿科学分会新生儿学组.新生儿缺氧缺血性脑病诊断标准[J].中华儿科杂志,2005,43(8):584-584.
[4] 母得志.新生儿缺氧缺血性脑病的诊断和治疗[J].实用儿科临床杂志,2011,26(14):1144-1147.
[5] 史玉泉.实用神经病学[M].上海:上海科学技术出版社,1995.961-1140.
[6] 张晓燕,芦红茹,宋红霞,等. 20项新生儿行为神经测定评分法对早产儿脑发育及脑损伤的评价[J].中国儿童保健杂志,2010,18(2):159-162.
[7] Battle DE.Diagnostic and statistical manual of mental disorders (DSM)[J].Codas,2013,25(2):191-192.
[8] Goswami I,Guillot M,Tam EWY.Predictors of long-term neurodevelopmental outcome of hypoxic-ischemic encephalopathy treated with therapeutic hypothermia[J].Semin Neurol,2020,40(3):322-334.
[9] Abbasi H,Unsworth CP.Applications of advanced signal processing and machine learning in the neonatal hypoxic-ischemic electroencephalogram[J].Neural Regen Res,2020,15(2):222-231.
[10] 曾保起,周庆欣,高乐,等.单唾液酸四己糖神经节苷脂治疗急性缺血性脑卒中的系统综述与Meta分析[J].中国新药杂志,2020,29(1):105-112.
[11] Koskela T,Kendall GS,Memon S,et al.Prognostic value of neonatal EEG following therapeutic hypothermia in survivors of hypoxic-ischemic encephalopathy[J].Clin Neurophysiol,2021,132(9):2091-2100.
[12] 林雨焮,冯骁,张艺丹,等.赵红缨.新生儿缺氧缺血性脑病不同复温时间亚低温治疗临床效果的前瞻性随机对照研究[J].中国当代儿科杂志,2023,25(4):350-356.
[13] 王葆辉,耿丽娟,刘俊.亚低温治疗的缺氧缺血性脑病新生儿MRI弥散值与长期神经预后的相关性[J].中国急救医学,2021,41(6):484-489.
[14] 肖惋翡,肖农,黄琴蓉,等.近红外脑功能成像技术在新生儿缺氧缺血性脑病亚低温治疗中的应用前景[J].中华物理医学与康复杂志,2022,44(1):92-94.