选择性头部亚低温治疗对新生儿缺氧缺血性脑病血清氧化应激因子及神经评分的影响  

Effect of selective head mild hypothermia therapy on serum oxidative stress factors and neonatal behavioral neurological assessment scores of neonates with hypoxic-ischemic encephalopathy

作　　者：唐萍[1] 冯欢欢[1] 刘莺[1] TANG Ping FENG Huan-Huan LIU Ying(Department of Neonatology, Xi＇an Gaoxin Hospital, Xi＇an, Shaanxi 710016, China)

机构地区：[1]西安高新医院新生儿科,陕西西安710016

出　　处：《中国妇幼保健》2017年第20期5005-5007,共3页Maternal and Child Health Care of China

摘　　要：目的探讨选择性头部亚低温治疗对新生儿缺氧缺血性脑病(HIE)血清氧化应激因子及神经评分的影响。方法选取2014年8月-2016年10月西安高新医院收治的HIE患儿88例,采用随机数字法将其分为对照组和观察组,每组各44例。对照组患儿接受常规综合治疗干预,观察组在此基础上接受选择性头部亚低温治疗,连续治疗28 d。比较两组患儿的治疗总有效率及治疗后神经行为评分(NBNA),比较治疗前后血清超氧化物歧化酶(SOD)、血清丙二醛(MDA)、白细胞介素-18(IL-18)及半胱氨酸天冬氨酸蛋白水解酶3(Caspase-3)水平。结果观察组治疗总有效率(95.45%)明显高于对照组(79.54%)(χ2=5.09,P=0.02);治疗后,观察组血清SOD水平明显高于对照组(P<0.01),MDA、IL-18及Caspase-3水平明显低于对照组(P<0.01);出生后14 d、28 d,观察组NBNA评分均明显高于对照组(P<0.05)。结论选择性头部亚低温治疗HIE的临床疗效显著,能降低脑部缺血再灌注后的氧化应激损伤,有效保护脑部神经,提高患儿预后质量,值得临床推广。Objective To explore the effect of selective head mild hypothermia therapy on serum oxidative stress factors and neonatal behavioral neurological assessment （NBNA） scores of neonates with hypoxic-ischemic eneephalopathy （HIE） . Methods Eighty-eight HIE neonates treated in the hospital from August 2014 to October 2016 were selected and divided into control group and observation group ac- cording to random nubmer table, 44 neonates in each group. The neonates in control group were treated by routine and comprehensive inter- vention, while the neonates in observation group were treated by routine and comprehensive intervention and selective head mild hypothermia therapy. The neonates in the two groups were treated for 28 days. The total effective rates of treatment and NBNA scores ＇after treatment in the two groups were compared. The levels of serum superoxide dismutase （SOD）, malondialdehyde （MDA）, interleukin-18 （IL-18）, and caspase-3 before and after treatment in the two groups were compared. Results The total effective rate of treatment in observation group was 95.45% , which was statistically significantly higher than that in control group （79.54%） （X2 = 5.09, P= 0. 02 ） . After treatment, serum SOD level in observation group was statistically significantly higher than that in control group （P〈0. 01 ） , the levels of serum MDA, IL-18, and caspase-3 in observation group were statistically significantly lower than those in control group （ P〈0. 01 ） . At 14 and 28 days after birth, NBNA scores in observation group were statistically significantly higher than those in control group （ P〈0. 05 ） . Conclusion The clinical effect of selective head mild hypothermia therapy in treatment of HIE is significant, selective head mild hypothermia therapy can re- duce oxidative stress injury after cerebral ischemia reperfusion, effectively protect brain nerve system, and improve the quality of prognosis, which is worthy of clinical promotion.

关 键 词：选择性头部亚低温 HIE 氧化应激因子 NBNA 

分 类 号：R722.1[医药卫生—儿科]