目的 探讨盐酸甲氯芬酯联合单唾液酸四己糖神经节苷脂治疗新生儿缺氧缺血性脑病的疗效观察。方法 选取2019年5月-2021年5月在南阳市中心医院治疗的98例新生儿缺氧缺血性脑病患儿,随机分为对照组(49例)和治疗组(49例)。对照组静脉滴注单唾液酸四己糖神经节苷脂注射液,20 mg/次,1次/d。治疗组在对照组的基础上静脉滴注注射用盐酸甲氯芬酯,60 mg/次,2次/d。两组患儿连续用药7 d。观察两组患者临床疗效,比较治疗前后两组患儿临床症状改善时间,血清白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、神经特异性烯醇化酶(NSE)、白细胞介素-6(IL-6)水平,及神经行为测定(NBNA)评分。结果 治疗后,治疗组患儿总有效率明显高于对照组(97.96% vs 81.63%,P<0.05)。治疗后,治疗组临床症状改善时间均早于对照组(P<0.05)。治疗后,两组患儿血清IL-6、IL-8、TNF-α、NSE水平均明显低于同组治疗前(P<0.05),且治疗组患儿明显低于对照组(P<0.05)。治疗后,两组患儿NBNA评分显著高于治疗前(P<0.05),且治疗组明显高于对照组(P<0.05)。结论 单唾液酸四己糖神经节苷脂联合盐酸甲氯芬酯治疗新生儿缺氧缺血性脑病效果明显,能有效降低脑部炎性反应,促进脑神经功能的恢复能力。

Objective To investigate the therapeutic effect of meclofenoxate combined with monosialotetrahexosylganglioside sodium in treatment of neonatal hypoxic-ischemic encephalopathy. Methods Children (98 cases) with neonatal hypoxic-ischemic encephalopathy in Nanyang Central Hospital from May 2019 to May 2021 were randomly divided into control (49 cases) and treatment (49 cases) group. Children in the control group were iv administered with Monosialotetrahexosylganglioside Sodium Injection, 20 mg/time, once daily. Children in the treatment group were iv administered with Meclofenoxate Hydrochloride for injection on the basis of the control group, 60 mg/time, twice daily. Children in two groups were treated for 7 d. After treatment, the clinical evaluation was evaluated, the improvement of clinical symptoms, the levels of serum IL-6, IL-8, TNF-α, and NSE, and NBNA scores in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was significantly higher than that of the control group (97.96% vs 81.63%, P < 0.05). After treatment, the improvement time of clinical symptoms in the treatment group was significantly earlier than that in the control group (P < 0.05). After treatment, the serum levels of IL-6, IL-8, TNF-α, and NSE in two groups were significantly lower than those before treatment (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the NBNA score in two groups was significantly higher than that before treatment (P < 0.05), and which in the treatment group was significantly higher than that of the control group (P < 0.05). Conclusion The combination of monosialotetrahexose ganglioside and meclofenoxate hydrochloride is effective in the treatment of neonatal hypoxic-ischemic encephalopathy, which can effectively reduce the inflammatory response in the brain and promote the recovery of brain nerve function.

R971

河南医学科技攻关项目（LHGJ20191453）