| 吴朋.小牛血去蛋白提取物联合神经节苷脂治疗新生儿缺氧缺血性脑病 46例[J].安徽医药,2021,25(11):2321-2324. |
| 小牛血去蛋白提取物联合神经节苷脂治疗新生儿缺氧缺血性脑病 46例 |
| Actovegin combined with ganglioside in the treatment of neonates with hypoxic-ischemic encephalopathy: 46 cases |
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| DOI：10.3969/j.issn.1009-6469.2021.11.048 |
| 中文关键词: 缺氧缺血，脑 婴儿，新生 小牛血去蛋白提取物 神经节苷脂 胶质纤维酸性蛋白 |
| 英文关键词: Hypoxia-Ischemia,brain Infant,newborn Actovegin Ganglioside Glial fibrillary acidic protein |
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| 目的探讨小牛血去蛋白提取物联合单唾液酸四己糖神经节苷脂( GM1)对新生儿缺氧缺血性脑病( HIE)原始反射恢复时间、血清胶质纤维酸性蛋白( GFAP)水平及智力发育指数( MDI)评分的影响。方法选取 2017年 3月至 2018年 10月天门市第一人民医院儿科收治的 HIE病儿 92例，使用随机数字表法将其分为对照组 46例和观察组 46例。对照组病儿在常规对症治疗基础上应用 GM1注射液进行治疗，观察组病儿在对照组基础上给予小牛血去蛋白提取物治疗，均连续治疗 14 d。治疗结束后，比较两组新生儿行为神经测定( NBNA)评分、临床症状改善情况、治疗总有效率、血清 GFAP水平、智力发育指数( MDI)评分及不良反应发生情况。结果治疗后观察组组与对照组病儿 NBNA评分分别为( 38.01±1.98)分、(34.25±5.07)分均明显高于治疗前( 16.84±3.99)分、(16.53±3.72)分( P<0.05)且观察组病儿显著高于对照组(P<0.05)。治疗结束后，观察组病儿原始反射、肌张力及意识恢复时间分别为( 4.28±1.06)d、(4.62，±1.33)d、(3.89±1.02)d均显著短于对照组病儿(6.90±2.11)d、(7.18±2.20) d、(5.77±1.85)d(P<0.05)；治疗总有效率 93.48%明显高于对照组的 76.09%(P<0.05)。治疗后观察组与对照组病儿血清 GFAP水平分别为(0.37±0.11)μg/L、(0.50±0.15)μg/L均显著低于治疗前(0.83±0.21)μg/L、(0.85±0.24)μg/L(P<0.05)，且观察组病儿明显低于对照组( P<0.05)。治疗结束后 6个月时，观察组与对照组病儿 MDI评分分别为( 92.18±7.69)分、(85.01±9.74)分均明显高于治疗结束后 3个月时评分( 83.12±11.36)分、(74.89±10.95)分( P<0.05)；治疗结束后 3、6个月时，观察组病儿 MDI评分均显著高于对照组( P<0.05)。两组病儿不良反应发生率相比，差异无统计学意义( P>0.05)。结论新生儿 HIE使用小牛血去蛋白提取物和 GM1联合治疗效果好，可明显改善临床症状，显著降低血清 GFAP水平，有助于促进脑神经发育，且安全性高。 |
| 英文摘要: |
| Objective To investigate the effects of actovegin combined with monosialotetrahexosyl ganglioside (GM1) on the recoverytime of primary reflex, level of serum glial fibrillary acidic protein (GFAP) and intelligence development index (MDI) score in neonateswith hypoxic-ischemic encephalopathy (HIE).Methods Ninety-two children with HIE admitted to Department of Pediatrics, The FirstPeople's Hospital of Tianmen from March 2017 to October 2018 were selected as subjects. They were assigned into control group (46 cases) and observation group (46 cases) by random number table method. The control group was treated with GM1 injection on the basis ofconventional symptomatic treatment, while the observation group was treated with actovegin on the basis of the control group for 14 days.After treatment, the scores of neonatal behavioral neurological measurement (NBNA), improvement of clinical symptoms, total effectiverate of treatment, level of serum GFAP, MDI and adverse reactions were compared between the two groups.Results After treatment, theNBNA scores of the observation group and the control group were (38.01±1.98) and (34.25±5.07) respectively, which were significantlyhigher than those before treatment [(16.84±3.99) and (16.53±3.72), P<0.05], and that in the observation group was significantly higher than that in the control group (P<0.05). After the treatment, the time of primary reflex, muscle tension and consciousness recovery in theobservation group were (4.28±1.06) d, (4.62±1.33) d, (3.89±1.02) d, respectively, which were significantly shorter than those in the control group [(6.90±2.11) d, (7.18±2.20) d, (5.77±1.85) d, P<0.05]. The total effective rate of treatment was 93.48%, which was significantly higher than 76.09% of the control group (P<0.05). After treatment, the serum GFAP levels in the observation group and the control groupwere (0.37±0.11) μg/L and (0.50 ±0.15) μg/L, respectively, which was significantly lower than that before treatment [(0.83±0.21) μg/Land (0.85±0.24) μg/L, P<0.05], and the serum GFAP levels of the observation group was significantly lower than that of the control group (P<0.05). 6 months after the end of treatment, the MDI scores of the observation group and the control group were (92.18±7.69) and(85.01±9.74) respectively, which were significantly higher than those of the 3 months after the end of treatment [(83.12±11.36) and(74.89±10.95), P<0.05], and at 3 and 6 months after the end of treatment, the MDI score of the observation group was significantly higherthan that of the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).Conclusion The combined treatment of actovegin and GM1 in neonates with HIE has a good effect. It can significantly improvethe clinical symptoms, significantly reduce the level of serum GFAP, help promote the development of brain nerves, and has a high safety. |
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