川芎嗪注射液对缺氧缺血性脑病新生儿血清胱抑素C和神经元特异性烯醇化酶的影响  

Effects of ligustrazine injection on serum cystatin C and neuron specific enolase in neonatal hypoxic ischemic encephalopathy

作　　者：任青[1] 姜中惠[1] 李丛[1] 魏丽夏[1] 张勇军[1] 杨巧芝[1] Ren Qing;Jiang Zhonghui;Li Cong;Wei Lixia;Zhang Yongjun;Yang Qiaozhi(Department of Pediatrics,Liaocheng People＇s Hospital,Liaocheng 252000,Shandong,China)

机构地区：[1]聊城市人民医院儿科,山东聊城252000

出　　处：《中国中西医结合急救杂志》2018年第5期458-462,共5页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：国家自然科学基金（11471152）

摘　　要：目的观察缺氧缺血性脑病（HIE）新生儿血清胱抑素C（CysC）和神经元特异性烯醇化酶（NSE）水平的变化，探讨川芎嗪注射液对中重度HIE患儿的器官保护作用。方法选择2014年10月至2017年10月聊城市人民医院新生儿病房住院的中重度HIE患儿43例，按治疗方法不同将患儿分为川芎嗪治疗组18例和常规治疗组25例；选取同期在本院出生的20例健康新生儿作为健康对照组。患儿人院后均给予“三对症、三支持”等常规治疗，于出生后6h内均给予选择性头部亚低温治疗，持续72h，川芎嗪治疗组于生后24h内加用盐酸川芎嗪注射液6mg·kg^-1·d^-1静脉滴注（静滴），每日1次，连用10d。于人院1d内和入院后7d检测血清CysC、NSE水平；于人院7d和14d进行行为神经评分（NBNA），采用直线相关分析法分析血清NSE与NBNA评分的相关性。结果出生后1d，川芎嗪治疗组和常规治疗组NSE、CysC均明显高于健康对照组[NSE（μg／L）：27．36±2．32、28．71±2．65比6．39±1．40，CysC（mg／L）：1．84±0．31、1．86±0．32比1．09±0．23，均P〈0．05]，但两组间比较差异无统计学意义（均P〉0．05）；出生后7d，川芎嗪治疗组和常规治疗组NSE和CysC较出生后1d明显降低，但仍明显高于健康对照组，且川芎嗪治疗组出生后7dNSE、CysC明显低于常规治疗组[NSE（μg／L）：16．71±1．89比21．15±1．97，CysC（mg，L）：1．20±0．20比1．34±0．19，均P〈0．05]。出生后7d，川芎嗪治疗组和常规治疗组NBNA明显低于健康对照组（分：37．06±1．43、36．28±1.31比38．75±0．97，均P〈0．01），出生后14d川芎嗪治疗组NBNA较出生后7d升高，且明显高于同期常规治疗组，但仍显著低于健康对照组（37．89±1．02比36．56±1．19、39．35±0．81，均P〈0．05）。HIE新生儿血清NSE水平与NBNA评分呈显著负相关（r=-0．470，P=0．001）。结论川芎嗪注射液Objective To investigate the level changes of serum cystatin C （CysC）, neuron specific enolase （NSE） in neonatal hypoxic ischemic encephalopathy （HIE） and explore the organ protection effect of ligustrazine injection on neonates with moderate and severe HIE. Methods Forty-three moderate and severe HIE neonates admitted to neonatal wards of the Liaocheng People＇s Hospital from October 2014 to October 2017 were enrolled, they were divided into ligustrazine treatment group （18 cases） and conventional treatment group （25 cases） according to different treatment methods; 20 cases of normal newborns at the same period in this hospital were selected as healthy control group. The two treatment groups received ＂three symptomatic＂ and ＂three supportive＂ conventional therapies after admission, and selective mild hypothermia was applied within 6 hours after birth for a duration of 72 hours： within 24 hours after birth, the ligustrazine treatment group received additionally ligustrazine treatment, ligustrazine hydrochloride injection 6 mg· kg^-1· d^-1 intravenous drip once a day for consecutive 10 days. Serum CysC and NSE levels were detected on the 1st day and 7th day after hospitalization; while scores of neonatal behavior neurological assessment （NBNA） were performed on the 7th day and 14th day after hospitalization, and the correlation between serum NSE and NBNA score was analyzed by linear correlation analysis. Results The levels of NSE and CysC in the ligustrazine treatment group and conventional treatment group were significantly higher than those in the healthy control group 1 day after birth [NSE （pg/L）： 27.36 ± 2.32, 28.71 ±2.65 vs. 6.39 ± 1.40, CysC （mg/L）： 1.84 ± 0.31, 1.86 ± 0.32 vs. 1.09 ± 0.23, all P 〈 0.05], however, no statistical significant differences were found between the ligustrazine treatment group and conventional treatment group （all P 〉 0.05）; the levels of NSE and CysC of the ligustrazine treatment group and the conventional treatment g

关 键 词：川芎嗪注射液 缺氧缺血性脑病 新生儿 胱抑素C 神经元特异性烯醇化酶 行为神经评分 

分 类 号：R743.33[医药卫生—神经病学与精神病学]