胞二磷胆碱治疗轻—中度新生儿缺氧缺血性脑病的临床观察  

Clinical Observation of Citicoline in The Treatment of Hypoxic Ischemic Encephalopathy in Newborns

作　　者：王冬梅[1] 李桂花[1] 贾春梅[1] 

机构地区：[1]包头市第四医院儿科,内蒙古包头014030

出　　处：《内蒙古医学杂志》2005年第3期215-217,共3页Inner Mongolia Medical Journal

摘　　要：目的:了解轻—中度新生儿缺氧缺血性脑病(HIE)时,患儿血糖,血钙及一氧化氮(NO)、一氧化氮合酶(NOS)的变化,探讨胞二磷胆碱对其的治疗价值。方法:对2 0 0 2年1月～2 0 0 4年10月包头市第四医院住院的4 8例轻—中度新生儿HIE患儿随机分为两组:治疗组2 5例,胞二磷胆碱12 5mg/d加入5 %GS5 0ml中,静脉点滴7d ;对照组2 3例常规治疗与治疗组一样,5 %GS 5 0ml/d静脉点滴7d ,且选择2 0例同期正常新生儿为正常组,于治疗前后进行新生儿神经行为(NBNA)评分并比较血糖、血钙及血中NO和NOS的变化。结果:新生儿HIE组NBNA评分低于正常组,血糖、NO、NOS值高于正常对照组,血钙低于正常对照组,差别有显著性。治疗后,治疗组NBNA评分明显上升,与对照组比较有显著性差别,但仍低于正常组,差别也有显著性;血糖、血钙恢复正常,3组之间无显著性差别;治疗组NO、NOS值下降与正常组无显著性差别,对照组虽有下降,但仍高于治疗组、正常组,差别有显著性。结论:新生儿HIE时,NBNA评分是临床诊断的敏感指标,且胞二磷胆碱治疗前后血糖、血钙、NO、NOS也有改变,其中NO、NOS值于胞二磷胆碱治疗后下降明显,有特异性,说明胞二磷胆碱对新生儿HIE有良好的治疗价值。Objective:To determine changes of blood glucose,blood calcium,nitric oxide(NO) and nitricoxide synthase(NOS)in newborns with hypoxic ischemic encephalopathy(HIE),and explore the efficacy of citicoline.Methods:48 cases of light-moderate HIE were randomly divided into two groups.The treatment group was given intravenouslu citicoline,125ms/d added in 50ml of 5% GS,for 7 days.Control group was treated with.Routine 5% GS,50ml/d,for 7 days.20 normal newborns were enrolled in normal group.Newborn nerve action(NBNA)before and after treatment were scored.The levels blood glucose,calcium,NO and NOS were determined and compared in groups.Results:In HIE group,scores of NBNA was lower that normals,the levels of blood glucose,NO and NOS higher that controls,that of blood calcium lower that contros,showing significant difference.After treatment,the scores is treatment group increased markedy,but lower than normals,showins significant difference.The levels of blood glucose and calcium recovered to normals,that of NO and NOS devreased,showing no differences.Conclusion:Scores of NBNA is a sensitive index of diagnosis in newborns with HIE.Citicoline is value in therapy for HIE,with characteristically decrease in NO and NOS.

关 键 词：新生儿缺氧缺血性脑病 胞二磷胆碱 一氧化氮 一氧化氮合酶 

分 类 号：R722.19[医药卫生—儿科]