神經(jīng)節(jié)苷脂和鼠神經(jīng)生長因子聯(lián)合治療新生兒缺氧缺血性腦病的可行性研究

謝越濤　曾志涌　安妮

【摘要】 目的 研究新生兒缺氧缺血性腦病患兒使用神經(jīng)節(jié)苷脂聯(lián)合鼠神經(jīng)生長因子治療的臨床效果。方法 60例新生兒缺氧缺血性腦病患兒， 按照隨機數(shù)字表法分為對照組和觀察組， 各30例。對照組患兒采用常規(guī)治療， 觀察組患兒在常規(guī)治療基礎上給予神經(jīng)節(jié)苷脂聯(lián)合鼠神經(jīng)生長因子治療。治療后， 比較兩組患兒新生兒神經(jīng)行為評分（NBNA）、智力發(fā)育指數(shù)（MDI）、心理運動發(fā)育指數(shù)（PDI）、臨床癥狀改善總有效率以及血清炎性因子水平。結果 觀察組患兒臨床癥狀改善總有效率為90.00%， 高于對照組的66.67%， 差異具有統(tǒng)計學意義（P<0.05）。觀察組患兒NBNA為（36.21±3.12）分、MDI為（91.24±3.35）分、PDI為（92.84±3.82）分， 明顯優(yōu)于對照組的（32.21±3.24）、（82.43±3.46）、（82.54±3.74）分， 差異具有統(tǒng)計學意義（P<0.05）。治療后， 兩組患兒血清炎性因子水平較治療前均明顯降低， 且觀察組降低程度明顯優(yōu)于對照組， 差異具有統(tǒng)計學意義（P<0.05）。結論 神經(jīng)節(jié)苷脂聯(lián)合鼠神經(jīng)生長因子治療可提高患兒治療效果， 患兒腦損傷恢復程度很好， 值得在臨床中推廣應用。

【關鍵詞】 神經(jīng)節(jié)苷脂；鼠神經(jīng)生長因子；早期干預；新生兒缺氧缺血性腦病

DOI：10.14163/j.cnki.11-5547/r.2016.35.005

【Abstract】 Objective To research clinical effect by gangliosides combined with mouse nerve growth factor in the treatment of neonatal hypoxic-ischemic encephalopathy. Methods A total of 60 newborn with neonatal hypoxic-ischemic encephalopathy were divided by random number table into control group and observation group， with 30 cases in each group. The control group received conventional therapy， and the observation group received additional gangliosides combined with mouse nerve growth factor for treatment. After treatment， comparison was made on neonatal behavioral neurological assessment （NBNA）， mental development index （MDI）， psychomotive development index （PDI）， total effective rate of clinical symptom improvement and serum inflammatory factor levels between the two groups. Results The observation group had total effective rate of clinical symptom improvement as 90.00%， which was higher than 66.67% in the control group， and the difference had statistical significance （P<0.05）. The observation group had NBNA as （36.21±3.12） points， MDI as （91.24±3.35） points and PDI as （92.84±3.82） points， which were all better than （32.21±3.24）， （82.43±3.46） and （82.54±3.74） points in the control group. Their difference had statistical significance （P<0.05）. After treatment， both groups had obviously lower serum inflammatory factor levels than those before treatment， while the observation group had much better decreased degree than the control group， and the difference had statistical significance （P<0.05）. Conclusion Combination of gangliosides and mouse nerve growth factor for treatment can improve curative effect， along with excellent recovery in cerebral injury. This method is worth clinical promotion and application.

【Key words】 Gangliosides； Mouse nerve growth factor； Early intervention； Neonatal hypoxic-ischemic encephalopathy

新生兒腦損傷是因為各種原因引發(fā)腦內(nèi)血流量減少或缺氧， 這種損傷醫(yī)學中稱新生兒缺氧缺血性腦病。缺氧缺血性腦病主要臨床癥狀為宮內(nèi)窒息， 在圍生期極易引起新生兒致殘或者死亡[1， 2]。缺氧缺血性腦病死亡率很高， 存活者常出現(xiàn)癲癇、智力低下以及腦性癱瘓等后遺癥?，F(xiàn)對新生兒缺氧缺血性腦病患兒使用神經(jīng)節(jié)苷脂聯(lián)合鼠神經(jīng)生長因子治療的情況進行分析， 發(fā)現(xiàn)效果很好。具體報告如下。