摘要
目的观察选择性头部亚低温疗法联合鼠神经生长因子治疗新生儿缺氧缺血性脑病(HIE)的疗效及其对氧化应激水平和炎症因子表达的影响。方法选择HIE患儿158例,采用随机数字表法分为观察组和对照组各79例。对照组患儿给予降颅内压、抗惊厥等常规治疗,同时给予选择性头部亚低温疗法;观察组在对照组治疗基础上给予鼠神经生长因子30μg,肌肉注射,1次/d,连续应用2周为1个疗程。观察并比较两组患儿临床症状改善情况、行为神经评分(NBNA)、心理运动发育指数(PDI)、智力发育指数(MDI)、氧化应激指标、炎性细胞因子、神经相关因子水平变化以及不良反应发生情况。结果观察组患儿意识、反射、肌张力、惊厥等临床症状的改善时间均显著短于对照组(均P<0.05)。治疗后2周观察组患儿NBNA、PDI、MDI、SOD和GSH-Px水平均显著高于对照组,MDA、NO、IL-4、IL-6、hs-CRP、TNF-α和NSE水平均显著低于对照组,差异均有统计学意义(均P<0.05)。治疗后2周两组患儿NBNA、PDI、MDI、SOD和GSH-Px水平均较治疗前显著增高,MDA、NO、IL-4、IL-6、hs-CRP、TNF-α和NSE水平均较治疗前显著降低,差异均有统计学意义(均P<0.05)。治疗后2周观察组NTF水平较治疗前显著增高,差异均有统计学意义(P<0.05);但对照组治疗前后NTF水平比较差异无统计学意义(P>0.05)。两组患儿治疗过程中均无严重不良反应发生。结论选择性头部亚低温疗法联合鼠神经生长因子治疗HIE的疗效确切,可显著改善患儿临床症状,降低脑组织氧化应激水平,减轻神经炎性损伤,优于单纯选择性头部亚低温疗法。
Objective To assess the efficacy of selective head mild hypothermia combined with murine nerve growth factor in treatment of neonatal hypoxic-ischemic encephalopathy（HIE） and its effect on oxidative stress and inflammatory factor expression. Methods One hundred and fifty eight neonates with HIE admitted from January 2014 to June 2016 were randomly assigned to two groups with 79 cases in each group. All patients received routine treatment and selective head hypothermia therapy, patients in study group received additional 30μg murine nerve growth factor i.m, g.d for 2 weeks. The changes of clinical symptoms, neurobehavioral scores（NBNA）, psychomotive development index（PDI）, mental development index（MDI）, oxidative stress index, inflammatory cytokines, neurocognitive factors and adverse reactions were observed and compared between two groups. Results The time for improvement of consciousness, reflex, muscle tension and convulsion in study group was significantly shorter than that in the control group（all P〈0.05）. The NBNA, PDI, MDI, SOD and GSH-Px levels were significantly increased and MDA, NO, IL-4, IL-6, hs-CRP, TNF-α and NSE levels were significantly decreased after two weeks of treatment compared to those before treatment in both groups（all P〈0.05）. The NBNA, PDI, MDI, SOD and GSH-Px in study group were significantly higher and the MDA, NO, IL-4, IL-6, hs-CRP, TNF-α and NSE levels were significantly lower than those in control group 2 weeks after the treatment（all P〈0.05）. The level of NTF in the study group was significantly higher than that before treatment（P〈0.05）, but there was no significant difference in NTF level in control group before and after treatment（P〈0.05）. No severe adverse reactions occurred in the two groups during the treatment. Conclusion Selective head mild hypothermia therapy combined with nerve growth factor can significantly improve the clinical symptoms, reduce the level of oxidative stress and neurological inflammatory injury in the treatment of neonate HIE.
出处
《浙江医学》
CAS
2017年第16期1337-1340,1344,共5页
Zhejiang Medical Journal
关键词
亚低温
缺氧缺血性脑病
新生儿
鼠神经生长因子
Mild hypothermia Hypoxic-ischemic encephalopathy Neonatal Rat nerve growth factor
