本文關(guān)鍵詞： 鼠神經(jīng)生長因子 神經(jīng)節(jié)苷脂 新生兒 缺血缺氧性腦病 炎癥反應(yīng) 氧化應(yīng)激　出處：《中國藥房》2017年17期 　論文類型：期刊論文

【摘要】：目的:評(píng)價(jià)鼠神經(jīng)生長因子聯(lián)合神經(jīng)節(jié)苷脂治療新生兒缺氧缺血性腦病(HIE)的臨床療效及安全性。方法:選取2013年1月-2015年1月于我院兒科治療的HIE患兒150例,按隨機(jī)數(shù)字表法分為對(duì)照組和觀察組,各75例。兩組患兒均給予糾正低血壓、降低顱內(nèi)壓等常規(guī)治療;對(duì)照組患兒在常規(guī)治療的基礎(chǔ)上給予單唾液酸四己糖神經(jīng)節(jié)苷脂鈉注射液20 mg加入10%葡萄糖注射液30~50 m L中,ivgtt,qd;觀察組患兒在對(duì)照組的基礎(chǔ)上加用注射用鼠神經(jīng)生長因子30μg加入注射用水2 m L中,im,qd。10 d為1個(gè)療程,兩組患兒均治療2個(gè)療程。比較兩組患兒的臨床療效,治療前后的新生兒神經(jīng)行為測定(NBNA)評(píng)分、相關(guān)實(shí)驗(yàn)室檢查指標(biāo)[白細(xì)胞介素10(IL-10)、腫瘤壞死因子α(TNF-α)、超氧化物歧化酶(SOD)、神經(jīng)元特異性烯醇化酶(NSE)、血管內(nèi)皮生長因子(VEGF)]水平,以及不良反應(yīng)和后遺癥(隨訪至1歲)的發(fā)生情況。結(jié)果:觀察組患兒的臨床總有效率為86.7%,明顯高于對(duì)照組的72.0%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。治療前,兩組患兒NBNA評(píng)分和實(shí)驗(yàn)室檢查指標(biāo)水平比較,差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。治療后第4、7、10天,兩組患兒NBNA評(píng)分均較治療前顯著升高,且觀察組評(píng)分顯著高于對(duì)照組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);治療后,兩組患兒血清IL-10、TNF-α、NSE和VEGF水平均較治療前顯著降低,SOD水平顯著升高,且觀察組指標(biāo)顯著優(yōu)于對(duì)照組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組患兒在治療期間均未見嚴(yán)重不良反應(yīng)發(fā)生。觀察組有64例患兒、對(duì)照組有60例患兒完成隨訪,觀察組患兒總后遺癥發(fā)生率為10.9%,顯著低于對(duì)照組的25.0%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:鼠神經(jīng)生長因子聯(lián)合神經(jīng)節(jié)苷脂治療新生兒HIE可有效減輕患兒腦組織炎癥反應(yīng)及氧化應(yīng)激損傷,加速腦組織功能的修復(fù),減少后遺癥的發(fā)生,且安全性較高。
[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 偽 (TNF- 偽), 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- 偽 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.
【作者單位】： 達(dá)州市中心醫(yī)院兒科;
【分類號(hào)】：R742
【正文快照】： 新生兒缺氧缺血性腦病(Hypoxic-ischemia encepha-lopathy,HIE)是指由圍產(chǎn)期各種原因引起的新生兒腦血流量降低或缺氧而導(dǎo)致的腦組織損傷。HIE作為新生兒窒息的主要并發(fā)癥之一,具有發(fā)病率高、致死率高、致殘率高等特點(diǎn)[1]。其中,腦組織原發(fā)性缺血缺氧損傷及再灌注損傷易誘發(fā)鈣

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