神经节苷脂和鼠神经生长因子联合治疗新生儿缺氧缺血性脑病的可行性研究

谢越涛　曾志涌　安妮

【摘要】 目的 研究新生儿缺氧缺血性脑病患儿使用神经节苷脂联合鼠神经生长因子治疗的临床效果。方法 60例新生儿缺氧缺血性脑病患儿， 按照随机数字表法分为对照组和观察组， 各30例。对照组患儿采用常规治疗， 观察组患儿在常规治疗基础上给予神经节苷脂联合鼠神经生长因子治疗。治疗后， 比较两组患儿新生儿神经行为评分（NBNA）、智力发育指数（MDI）、心理运动发育指数（PDI）、临床症状改善总有效率以及血清炎性因子水平。结果 观察组患儿临床症状改善总有效率为90.00%， 高于对照组的66.67%， 差异具有统计学意义（P<0.05）。观察组患儿NBNA为（36.21±3.12）分、MDI为（91.24±3.35）分、PDI为（92.84±3.82）分， 明显优于对照组的（32.21±3.24）、（82.43±3.46）、（82.54±3.74）分， 差异具有统计学意义（P<0.05）。治疗后， 两组患儿血清炎性因子水平较治疗前均明显降低， 且观察组降低程度明显优于对照组， 差异具有统计学意义（P<0.05）。结论 神经节苷脂联合鼠神经生长因子治疗可提高患儿治疗效果， 患儿脑损伤恢复程度很好， 值得在临床中推广应用。

【关键词】 神经节苷脂；鼠神经生长因子；早期干预；新生儿缺氧缺血性脑病

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

新生兒脑损伤是因为各种原因引发脑内血流量减少或缺氧， 这种损伤医学中称新生儿缺氧缺血性脑病。缺氧缺血性脑病主要临床症状为宫内窒息， 在围生期极易引起新生儿致残或者死亡[1， 2]。缺氧缺血性脑病死亡率很高， 存活者常出现癫痫、智力低下以及脑性瘫痪等后遗症。现对新生儿缺氧缺血性脑病患儿使用神经节苷脂联合鼠神经生长因子治疗的情况进行分析， 发现效果很好。具体报告如下。