目的 探讨三磷酸胞苷二钠联合鼠神经生长因子治疗新生儿缺氧缺血性脑病的临床疗效。方法 选择2013年1月-2014年1月徐州市妇幼保健院新生儿科收治的缺氧缺血性脑病患儿80例,随机分为对照组和治疗组,每组各40例。对照组在基本治疗的基础上,在患儿出生后6 h内肌肉注射注射用鼠神经生长因子,30μg/次,1次/d。治疗组在对照组的治疗基础上静脉滴注注射用三磷酸胞苷二钠,100 mg/次加入到5%葡萄糖溶液30 mL中,1次/d。中度患儿治疗14 d,重度患儿治疗21 d。观察两组的临床疗效,同时比较两组患儿症状与体征改善时间、行为神经测试(NBNA)评分、智能发育量表(CDCC)测试结果。结果 治疗后,对照组和治疗组的总有效率分别为72.5%、92.5%,两组比较差异有统计学意义(P < 0.05)。治疗组意识障碍恢复时间、惊厥停止时间、原始反射正常时间和肌张力正常时间均显著短于对照组,两组比较差异有统计学意义(P < 0.05)。治疗后,两组患儿行为能力评分、被动肌张力评分、一般评估评分、总分均显著升高,治疗组主动肌张力评分、原始反射评分显著升高,同组治疗前后差异具有统计学意义(P < 0.05);且治疗组这些观察指标的改善程度优于对照组,两组比较差异具有统计学意义(P < 0.05)。两组患儿出生后6、12个月CDCC检测显示治疗组智能发育指数(MDI)、运动发育指数(PDI)均明显高于对照组,两组比较差异均具有统计学意义(P < 0.05)。结论 三磷酸胞苷二钠联合鼠神经生长因子治疗新生儿缺氧缺血性脑病具有较好的临床疗效,可改善患儿神经功能和生存质量,具有一定的临床推广应用价值。

Objective To observe the clinical efficacy of cytidine disodium triphosphate combined with mouse nerve growth factor in treatment of neonatal hypoxic ischemic encephalopathy. Methods Patients (80 cases) with hypoxic ischemic encephalopathy in Department of Neonatology of Xuzhou Maternity and Child Health Hospital from January 2013 to January 2014 were randomly divided into control and treatment groups, and each group had 40 cases. The patients in control group were im administered with Mouse Nerve Growth Factor for injection 6 h after birth on the basis of foundation treatment, 30 μg/time, once daily. The patients in treatment group were iv administered with Cytidine Disodium Triphosphate for injection on the basis of control group, 100 mg/time added into 5% glucose injection 30 mL, once daily. Children with moderate were treated for 14 d, and children with severe were treated for 21 d. After treatment, the efficacy was evaluated, and symptoms and signs improved time, NBNA scores, and CDCC test results in two groups were compared. Results After treatment, the efficacies in the control and treatment groups were 72.5% and 92.5%, respectively, and there were differences between two groups (P < 0.05). After treatment, consciousness disturbance recovery time, seizures stop time, primitive reflex normal time, and muscle tension normal time in the treatment group were shorter than those in the control group, and there were differences between two groups (P < 0.05). After treatment, behavior ability score, passive muscle tension score, general assessment score and total score in two groups were significantly increased, and active muscle tension score and primitive reflex score in the treatment group were significantly increased, and the difference was statistically significant in the same group (P < 0.05). These observational indexes in the treatment group were better than those in the control group, with significant difference between two groups (P < 0.05). After birth of 6 and 12 months, MDI and PDI in treatment group were higher than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Cytidine disodium triphosphate combined with mouse nerve growth factor has good clinical curative effect in treatment of neonatal hypoxic ischemic encephalopathy, and can improve neural function and life quality, which has certain clinical application value.