促红细胞生成素与亚低温治疗在足月新生儿缺氧缺血性脑病中的疗效对比  

Effectiveness comparison of Erythropoietin and Mild Hypothermia in Full-term Neonates with Hypoxic-ischemic Encephalopathy

作　　者：尚云[1] 夏于荣 郭喜霞[1] 马慧敏[1] SHANG Yun(The First Affiliated Hospital of Xin Xiang Medical University,Henan Xinxiang 453100,China)

机构地区：[1]河南新乡医学院第一附属医院,河南新乡453100 [2]贵州省安顺市妇幼保健院儿科,贵州安顺561000

出　　处：《河北医学》2019年第2期292-296,共5页Hebei Medicine

基　　金：河南省神经修复重点实验室开放课题项目;(编号:HNSJXF-2016-019)

摘　　要：目的:探讨促红细胞生成素(EPO)、亚低温以及其联合治疗在足月新生儿缺氧缺血性脑病(HIE)治疗中疗效对比。方法:本研究为临床实验研究,以2015年1月至2018年1月新生儿科临床确诊的100例中重度HIE患儿为研究对象,随机分成常规组,仅行常规治疗,EPO组,常规+EPO治疗,亚低温组,常规+亚低温治疗,联合组,常规+EPO+亚低温组,正常健康新生儿为对照组,各组均25人,比较入院时及入院后72h血清中白细胞介素6(IL-6)、肿瘤坏死因子-a(TNF-a)的变化,以及入院3d、14d新生儿神经行为(NBNA)评分的变化。结果:常规组、EPO组、亚低温组、联合组、对照组中IL-6及TNF-a表达水平均逐渐降低,组间两两比较,差异均有统计学意义(P <0.05),入院14d新生儿NBNA评分4组比较逐渐增高,组间比较差异均有统计学意义(P<0.05)。结论:多种治疗方案中,促红细胞生成素联合亚低温中IL-6及TNF-a水平最低,新生儿神经行为评分最高,提示脑损伤最轻,恢复最快,对于新生儿缺氧缺血性脑病治疗效果最好,减轻患儿脑损伤,保护神经系统,改善预后。Objective:To compare the efficacy of erythropoietin(EPO),mild hypothermia and their combination in the treatment of hypoxic-ischemic encephalopathy in full-term neonates.Methods:This study was a clinical experimental study.From January 2015 to January 2018,100 children with moderate to severe HIE were randomly divided into routine group,EPO group,routine+EPO group,mild hypothermia group,routine+mild hypothermia group,combined group,routine+EPO+mild hypothermia group,normal healthy newborn group.In the control group,there were 25 persons in each group.The changes of serum IL-6 and TNF-a at admission and 72 hours after admission were compared,and the changes of neonatal neurobehavioral(NBNA)scores at 3 and 14 days after admission were compared.Results:The expression levels of IL-6 and TNF-a in routine group,EPO group,mild hypothermia group,combination group and control group decreased gradually.There were significant differences between the two groups(P<0.05).The NBNA score of newborns in four groups increased gradually after 14 days of admission,and there were significant differences between the two groups(P<0.05).Conclusion:Among various treatments,erythropoietin combined with mild hypothermia had the lowest levels of IL-6 and TNF-a,and the highest neurobehavioral score of newborns,suggesting that brain injury was the lightest and recovery was the fastest.It had the best therapeutic effect on neonatal hypoxic-ischemic encephalopathy,reducing brain injury,protecting nervous system and improving prognosis.

关 键 词：新生儿缺氧缺血性脑病 白细胞介素-6 肿瘤坏死因子-A 

分 类 号：R742[医药卫生—神经病学与精神病学]