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
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篇名: 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
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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 mL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30 μg加入注射用水2 mL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(P<0.05)。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(P>0.05)。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(P<0.05);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(P<0.05)。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(P<0.05)。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 clinical efficacy and safety of mouse nerve growth factor combined with ganglioside in the treatment of hypoxic-ischemic encephalopathy (HIE). METHODS: A total of 150 HIE children in pediatric department of our hospital during Jan. 2013-Jan. 2015 were divided into control group and observation group according to random number table, with 75 cases in each group. Both groups received routine treatment as correcting hypotension, reducing intracranial pressure, etc. Control group was additionally given Monosialotetrahexosylganglioside sodium injection 20 mg added into 10% Glucose injection 30-50 mL, ivgtt, qd. Observation group was additionally given Mouse nerve growth factor for injection 30 μg added into Water for injection 2 mL, im, qd, on the basis of control group. A treatment course lasted for 10 days, and both groups received 2 courses of treatment. Clinical efficacies of 2 groups were compared as well as NBNA score, the levels of related lab test indexes (IL-10, TNF-α, SOD, NSE, VEGF) before and after treatment, the occurrence of ADR and sequela (following up to 1 year old). RESULTS: The response rate of observation group was 86.7%, which was significantly higher than 72.0% of control group, with statistical significance (P<0.05). Before treatment, there was no statistical significance in NBNA scores or related lab test index levels between 2 groups (P>0.05). On 4th,7th, 10th day after treatment, NBNA scores of 2 groups were increased significantly, compared to before treatment; the observation group was significantly higher than the control group, with statistical significance (P<0.05). After treatment, serum levels of IL-10, TNF-α, NSE and VEGF in 2 groups were decreased significantly, compared to before treatment, SOD levels were increased significantly, and the observation group was significantly better than the control group, with statistical significance (P<0.05). No obvious ADR was found in 2 groups during treatment. Totally 64 children in observation group and 60 in control group completed follow-up. The total incidence of sequela in observation group was 10.9%, which was significantly lower than 25.0% of control group, with statistical significance (P<0.05). CONCLUSIONS: For neonatal HIE, mouse nerve growth factor combined with ganglioside can effectively relieve brain tissue inflammatory reaction and oxidative stress injury, accelerate the recovery of cerebral tissue and reduce the occurrence of sequela with good safety.
期刊: 2017年第28卷第17期
作者: 唐国红,雷克竞
AUTHORS: TANG Guohong,LEI Kejing
关键字: 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
KEYWORDS: Mouse nerve growth factor; Ganglioside; Neonatal; Hypoxic-ischemic encephalopathy; Inflammatory reaction; Oxidative stress
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