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[摘要]
目的 探究在新生儿缺氧缺血性脑病的治疗中应用神经节苷脂的临床疗效及对血清炎症因子的影响。方法 随机选取上海交通大学医学院附属新华医院2015年2月—2017年2月收治的新生儿缺氧缺血性脑病(HIE)的患儿共54例,并随机分为观察组(n=27)和对照组(n=27)。两组患者均应用同样的基础治疗,对照组患者加用注射用胞磷胆碱钠0.5 g/d,观察组患者则应用神经节苷脂注射液20 mg/d,疗程均为2周。分别比较治疗前后患者的治疗有效率、血气分析结果、血清炎症因子水平和NBNA评分。结果 1个疗程后,观察组患者的治疗有效率(88.9%)显著高于对照组(66.7%),差异有统计学意义(P<0.05)。治疗前,两组患者的pH值、血氧分压(pO2)、血二氧化碳分压(pCO2)和动脉血氧饱和度(SaO2)无显著差异;治疗后,两组以上各项指标均有显著的改善,同组治疗前后比较差异有统计学意义(P<0.05);且观察组的pO2、pCO2和SaO2均较对照组显著改善,组间差异有统计学意义(P<0.05)。治疗前,两组患儿白介素-2(IL-2)、白介素-6(IL-6)、超敏C反应蛋白(hs-CRP)和肿瘤坏死因子-α(TNF-α)水平无显著差异。治疗后,两组IL-2的水平较治疗前均有显著升高,IL-6、hs-CRP和TNF-α的水平对比治疗前有显著下降,同组治疗前后比较差异有统计学意义(P<0.05);且观察组的IL-2水平较对照组显著更高,而IL-6、hs-CRP和TNF-α的水平观察组显著低于对照组,组间差异有统计学意义(P<0.05)。治疗后两组患者评分均有改善,同组治疗前后比较差异有统计学意义(P<0.05);且观察组的评分显著高于对照组,组间差异有统计学意义(P<0.05)。结论 神经节苷脂治疗HIE患者的疗效确实,对于血清炎症因子水平的升高具有有效的抑制作用,值得临床推广应用。
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[Abstract]
Objective To investigate the clinical efficacy of ganglioside in the treatment of hypoxic-ischemic encephalopathy (HIE) and its influence on serum inflammatory factors. Methods 54 children with HIE in our hospital from February 2015 to February 2017 were randomly selected and divided into two groups:the observation group (n=27) and the control group (n=27). The observation group was treated with gangliosides, while the control group was treated with citicoline. The treatment effective rate, blood gas analysis, serum inflammatory factors and NBNA score were compared before and after treatment.Results After a course of treatment, the effective rate of observation group (88.9%) was significantly higher than the control group (66.7%). Before treatment, there was no significant difference in pH value, partial pressure of oxygen (pO2), partial pressure of carbon dioxide (pCO2) and arterial oxygen saturation (SaO2) between the two groups; after treatment, the above indexes of the two groups were significantly improved, and there was significant difference between the two groups before and after treatment (P<0.05). Compared with the control group, the difference was statistically significant (P<0.05). Before treatment, there was no significant difference in the levels of interleukin-2 (IL-2), interleukin-6 (IL-6), hypersensitive C-reactive protein (hs-CRP) and tumor necrosis factor-alpha (TNFalpha) between the two groups. After treatment, the levels of IL-2 in both groups were significantly higher than those before treatment, while the levels of IL-6, hs-CRP and TNF-alpha were significantly lower than those before treatment, and there was a significant difference between the two groups before and after treatment (P<0.05); the levels of IL-2 in the observation group were significantly higher than those in the control group, while the levels of IL-6, hs-CRP and TNF-alpha in the observation group were significantly lower than those in the control group. In the control group, the difference was statistically significant (P<0.05). After treatment, the scores of the two groups were improved, and there was significant difference between the same group before and after treatment (P<0.05); and the scores of the observation group were significantly higher than those of the control group, the difference between the two groups was statistically significant (P<0.05). Conclusion Ganglioside is effective in HIE, which also has an effective inhibitory effect on the elevation of serum inflammatory factors. It is worthy of clinical application.
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