摘要
目的:比较单唾液酸四己糖神经节苷脂与胞二磷胆碱治疗中度新生儿缺血缺氧性脑病的疗效。方法:将2014年7月至2016年1月收治的148例中度缺血缺氧性脑病患儿随机分为A、B两组,每组74例,两组患儿均在常规治疗基础上分别给予单唾液酸四己糖神经节苷脂和胞二磷胆碱治疗,比较两组患儿评价两组患儿治疗后意识、肌张力及原始反射恢复时间的差异,记录两组患儿治疗7dNBNA评分、血清标志物浓度变化,判定临床疗效差异。结果:A组患儿治疗后意识恢复(2.82±0.52vs3.44±0.85)d、肌张力恢复(4.43±1.75vs5.35±1.45)d、原始反射恢复时间(4.12±1.09vs4.90±1.15)d及脑水肿消退时间(3.15±0.73vs3.85±0.93)d均明显早于B组患儿(P<0.05);A组患儿治疗7dNBNA评分提高数值高于B组(6.4±1.5vs4.7±1.0,P<0.05),血清TNF-α;(69.5±13.8vs54.5±10.5)pg·mL^(-1)、IL-6(49.7±9.5 vs 41.8±7.9)pg·mL^(-1)、CRP(29.9±6.2 vs 25.6±5.6)mg·L^(-1)、NES(10.5±3.9vs7.8±3.1)μg·L^(-1)下降数值均高于B组(P<0.05);A组治疗7d总有效率高于B组(93.2%vs81.1%,P<0.05)。治疗后两组病死率(1.4%vs2.7%)、后遗症发生率(2.7%vs8.1%)差异均无统计学意义(P>0.05)。结论:单唾液酸四己糖神经节苷脂钠可辅助降低缺血缺氧性脑病新生儿炎性反应水平,改善临床症状体征,早期疗效优于胞二磷胆碱。
Objective： To compare monosialotetrahexosyl ganglioside versus cytidine diphosphate in treatment of moderate neonatal hypoxic ischemic encephalopathy（HIE）. Methods ： Totally 148 cases who were hospitalized from July 2014 to January 2016 were randomly divided into group A and B, each group with 74 cases, for whom monosialotetrahexosyl ganglioside or cytidine diphosphate treatment was given respectively based on conventional treatment The recovery time of consciousness, muscle tension and primitive reflex after treatment were compared Change of NBNA score. concentrations of serum markers and clinical efficacies after 7 d of treatment were noted and determined. Results： After the treatment. the children in group A had earlier recovery time of consciousness（2.82 ± 0. 52 vs 3. 44 ± 0. 85） days, muscle tension（4 43 ± 1. 75 vs 5.35 ± 1. 45） days, primitive reflex（4 12 ± 1. 09 vs 4 90 ± 1.15） days and brain edema regression time（3.15 ± 0.73 vs 3. 85 ± 0.93）days than group B patients（P 〈0. 05）Group A had larger NBNA increase after treatment for 7 d than group B（6.4 ± 1. 5 vs 4. 7 ± 1. 0, P〈0.05）, and greater decrease of serum TNF-α（69.5±13.8 vs 545±10.5） pg ·ML^（-1）,IL-6（49.7 ±9.5 vs41.8±7.9）pg ·ML^（-1）,CRP（29.9±2 vs 25.6±5.6） mg · L^（-1）,NES（10.5±3.9 vs 7.8±3.1） μg· L^（-1） than thoes of group B（P 〈0. 05）. The total effective rate of group A after treatment for 7 d was significantly higher than group B（93.2% vs 81. 3%, P 0.05）. The fatality rate after treatment（1. 4% vs 2. 7%） and incidence of sequelaes（2. 7% vs 8. 1%） had no statistically significant differences（P〉 0.05）. Conclusion： Monosialotetrahexosyl ganglioside can help reduce inflammatory reaction of the neonatal HIE and improve clinical symptoms and signs, and its early efficacy is better than cytidine diphosphate choline.
作者
者桂莲
张靖
霍志艳
张琪
刘苗
孙金侠
连喜院
ZHE Gui-lian;ZHANG Jin;HUO Zhi-yan;ZHANG Qi;LIU Miao;SUNJln-xia;LIAN Xi-yuan(Department of Neonatal.Jingbian People＇ s Hospital,Shaanxi Jingbian 718500,China;Department of Neonatal,Pingliang People＇ s Hospital,Gansu Pingliang 744000,China)
出处
《临床药物治疗杂志》
2018年第6期81-85,共5页
Clinical Medication Journal
基金
甘肃省高等学校科学研究项目(2015B-138)
