枸橼酸咖啡因联合苯巴比妥对早产儿脑损伤患儿NF-κB、TLR2的影响  

Effect of caffeine citrate plus phenobarbital on serum NF-κB and TLR2 in preterm infants with brain injury

作　　者：季菊花[1] 徐明[1] 洪菲[1] 宋磊[1] Ji Juhua;Xu Ming;Hong Fei;Song Lei(Department of Pediatrics,Nantong First People's Hospital,the Second Affiliated Hospital of Nantong University,Nantong 226000,China)

机构地区：[1]南通市第一人民医院南通大学第二附属医院儿科,江苏南通226000

出　　处：《中华临床医师杂志（电子版）》2022年第2期141-145,共5页Chinese Journal of Clinicians(Electronic Edition)

基　　金：南通市科技项目-社会民生科技-公众健康(MS12020004);江苏省妇幼健康科研项目(F202065)2。

摘　　要：目的探讨枸橼酸咖啡因联合苯巴比妥对早产儿脑损伤患儿核转录因子κB(NF-κB)、Toll受体2(TLR2)的影响。方法在患儿监护人同意前提下选取2018年4月至2021年4月在南通大学第二附属医院出生的183例早产儿脑损伤患儿为研究对象,数字表法分为苯巴比妥治疗的单药组(91例)及枸橼酸咖啡因、苯巴比妥联合治疗的联合组(92例)。对比2组患儿神经行为能力,检测神经损伤标志物、炎性因子及NF-κB、TLR2水平,分析临床疗效。结果治疗后,联合组一般反应、行为能力、被动肌张力、主动肌张力、原始反射评分高于单药组(P<0.05);治疗后,血清髓鞘碱性蛋白(MBP)、神经元特异性烯醇化酶(NSE)、S100β蛋白(S100β)、NF-κB、TLR2、白介素6(IL-6)、超敏C反应蛋白(hs-CRP)水平降低,且联合组以上指标的水平低于单药组(P<0.05)。联合组临床治疗总有效率高于单药组(P<0.05)。结论枸橼酸咖啡因、苯巴比妥联合应用有效提高早产儿脑损伤患儿临床疗效,改善患儿神经行为,调控NF-κB、TLR2水平,抑制炎性反应,减轻脑损伤程度,疗效显著。Objective To explore the effects of caffeine citrate combined with phenobarbital on the levels of serum nuclear transcription factorκB(NF-κB)and Toll receptor 2(TLR2)in premature infants with brain injury.Methods A total of 183 premature infants with brain injury born at the Second Affiliated Hospital of Nantong University from April 2018 to April 2021 were selected as the research subjects under the consent of their guardians,and were divided into a phenobarbital alone group(91 cases)and caffeine citrate plus phenobarbital group(92 cases)by the digital table method.The neurobehavioral ability of children in the two groups was compared,and the levels of nerve injury markers,inflammatory factors,and expression of NF-κB and TLR2 were detected,and the clinical efficacy was analyzed.Results After treatment,the scores of general response,behavioral ability,passive muscle tone,active muscle tone,and original reflex in the combination group were higher than those in the phenobarbital alone group(P<0.05).After treatment,serum levels of myelin basic protein(MBP),neuron-specific enolase(NSE),S100 protein(S100),NF-B,TLR2,interleukin 6(IL-6),and hypersensitive C-reactive protein(hs-CRP)were decreased in both groups,and the levels of these indexes in the combination group were lower than those in the monotherapy group(P<0.05).The total effective rate of the combination group was higher than that of the monotherapy group(P<0.05).Conclusion Combined application of caffeine citrate and phenobarbital can effectively enhance the clinical efficacy,improve the neurological behavior,regulate the levels of NF-κB and TLR2,inhibit the inflammatory response,and reduce the degree of brain injury in preterm infants.

关 键 词：枸橼酸咖啡因 苯巴比妥 早产儿脑损伤 核转录因子ΚB Toll受体2 

分 类 号：R722.6[医药卫生—儿科]