选择性头部亚低温疗法联合鼠神经生长因子治疗新生儿缺氧缺血性脑病的疗效及其对氧化应激水平和炎症因子表达的影响  

Curative effect of selective head sub-hypothermia therapy combined with mouse nerve growth factor in treatment of neonatal hypoxic-ischemic encephalopathy and the impact on oxidative stress level and expressions of inflammatory factors

作　　者：耿淑霞[1] 朱君丽[1] 田婷[1] 郭玮[1] 谷惠芳[1] 王敬群[1] 刘鹏[1] 

机构地区：[1]邢台市人民医院新生儿科,河北邢台054000

出　　处：《中国妇幼保健》2017年第15期3542-3546,共5页Maternal and Child Health Care of China

基　　金：邢台市科技计划项目(2015ZC069)

摘　　要：目的观察选择性头部亚低温疗法联合鼠神经生长因子治疗新生儿缺氧缺血性脑病(HIE)的疗效及其对氧化应激水平和炎症因子表达的影响。方法采用随机数字表法将108例HIE患儿分为观察组和对照组,每组各54例。对照组患儿给予降颅压、抗惊厥等常规治疗,同时给予选择性头部亚低温疗法。观察组在对照组治疗基础上给予鼠神经生长因子30μg,肌肉注射,1次/d,连续应用2周为1个疗程。观察两组患儿临床症状改善情况、行为神经评分(NBNA)、心理运动发育指数(PDI)和智力发育指数(MDI)、氧化应激指标、炎性细胞因子及神经相关因子水平变化,观察不良反应发生情况。结果观察组患儿意识、反射、肌张力、惊厥等临床症状的改善时间显著短于对照组(P<0.05)。经治疗后2周,两组患儿NBNA评分、MDI指数及PDI指数均较治疗前显著提高(P<0.05),且治疗后观察组各项评分显著高于对照组(P<0.05)。两组患儿超氧化物歧化酶(SOD)和谷胱甘肽过氧化物酶(GSH-Px)水平均较治疗前显著增高,丙二醛(MDA)和一氧化氮(NO)水平均显著降低(P<0.05)。其中,观察组治疗后SOD和GSH-Px水平显著高于对照组,MDA和NO水平均显著低于对照组治疗后(P<0.05)。治疗后2周,两组患儿各项炎性细胞因子水平均较治疗前显著降低(P<0.05)。且观察组治疗后各项炎性细胞因子水平显著低于对照组治疗后(P<0.05)。两组患儿神经元特异性烯醇化酶(NSE)水平较治疗前显著降低(P<0.05)。观察组治疗后NSE水平显著低于对照组治疗后(P<0.05)。观察组神经营养因子(NTF)水平较治疗前显著增高(P<0.05)。对照组NTF水平较治疗前略增高(P>0.05)。两组患儿治疗过程中均无严重不良反应发生。结论选择性头部亚低温疗法联合鼠神经生长因子治疗HIE的疗效确切,可显著改善患儿临床症状,降低脑组织氧化应激水平,减轻神经炎性损伤,优于单纯选择性头部�Objective To observe the therapeutic effect of selective head sub-hypothermia combined with mouse nerve growth factor in treatment of neonatal hypoxic-ischemic encephalopathy（ HIE） and the impact on oxidative stress level and expressions of inflammatory factors. Methods A total of 108 children with HIE were selected and divided into observation group and control group by random number table,54 children in each group. The children in control group were treated with routine treatment,such as intracranial pressure reduction,anticonvulsant,and selective head sub-hypothermia therapy. In observation group,the children were treated with routine treatment and intramuscular injection of mouse nerve growth factor（ 30 μg）,once a day,one course of treatment included 2 weeks. The improvements of clinical symptoms,NBNA scores,psychomotor development index（ PDI）,mental development index（ MDI）,oxidative stress index,inflammatory cytokines,nerve-related factors,and adverse reactions in the two groups were observed and compared. Results The improvement time of consciousness,reflex,muscular tension,and convulsion in observation group was statistically significantly shorter than that in control group（ P〈0. 05）. After 2 weeks of treatment,NBNA score,MDI,and PDI in the two groups were statistically significantly higher than those before treatment（ P〈0. 05）,and the scores in observation group after treatment were statistically significantly higher than those in control group after treatment（ P〈0. 05）. The levels of superoxide dismutase（ SOD） and glutathione peroxidase（ GSH-Px） in the two groups after treatment were statistically significantly higher than those before treatment,while the levels of malondialdehyde（ MDA） and nitric oxide（ NO） after treatment in the two groups significantly decreased（ P〈0. 05）. After treatment,the levels of SOD and GSH-Px in observation group were statistically significantly higher than those in control group（ P〈0. 05）,while the levels of MDA a

关 键 词：亚低温 缺氧缺血性脑病 新生儿 鼠神经生长因子 

分 类 号：R651.1[医药卫生—外科学]