亚低温联合促红细胞生成素对HIE患儿脑部生理和神经系统发育的改善作用  

Effect of Mild Hypothermia Combined with Erythropoietin on Brain Physiology and Nervous System Development in Newborns with HIE

作　　者：余静 薛伟 李亚萍 YU Jing;XUE Wei;LI Yaping(Department of Pediatrics,Xinyang Central Hospital,Xinyang Henan 464000,China)

机构地区：[1]信阳市中心医院儿科,河南信阳464000

出　　处：《临床研究》2023年第5期65-68,共4页Clinical Research

摘　　要：目的探讨亚低温联合促红细胞生成素治疗新生儿缺氧缺血性脑病(HIE)的临床效果。方法选择在信阳市中心医院儿科2015年7月至2018年6月就诊的70例HIE患儿作为研究对象,根据治疗方式分为对照组(33例)和观察组(37例),并根据治疗开始时间分为发病<6 h和发病≥6 h。比较两组患儿的振幅整合脑电图(aEEG)评分、神经元特异性烯醇化酶(NSE)水平及贝利婴儿发展量表(BSID)评分。结果治疗3天后,疾病程度为轻度的两组HIE患儿aEEG评分及NSE水平差异无统计学意义(P>0.05)。观察组中度和重度HIE患儿aEEG评分及NSE水平显著低于对照组,差异有统计学意义(P<0.05)。观察组治疗开始时间<6 h的中度和重度HIE患儿aEEG评分及NSE水平显著低于治疗开始时间≥6 h的患儿,差异有统计学意义(P<0.05)。两组患儿治疗开始时间<6 h MDI评分均显著高于治疗开始时间≥6 h的患儿,并且相同时间段内,观察组MDI评分显著高于对照组,差异有统计学意义(P<0.05)。观察组患儿PDI评分显著高于对照组,差异有统计学意义(P<0.05)。同组内治疗开始时间<6 h和≥6 h的PDI评分比较差异无统计学意义(P>0.05)。结论HIE患儿的最佳治疗开始时间为发病6 h以内,且采用亚低温联合促红细胞生成素治疗HIE患儿具有较好的疗效,可显著改善患儿的脑部生理和神经系统发育。Objective To investigate the clinical effect of mild hypothermia combined with erythropoietin in the treatment of neonatal hypoxic ischemic encephalopathy(HIE).Methods From July 2015 to June 2018,a total of 70 newborns with HIE who were admitted to the Department of Pediatrics of Xinyang Central Hospital were selected as subjects.According to the treatment,they were divided into control group(33 cases)and observation group(37 cases).According to the time of onset of treatment,the patients were divided into<6 hours of onset and≥6 hours of onset.Amplitude-integrated electroencephalogram(aEEG)scores,neuron-specific enolase(NSE)levels,and the Bailey Infant Development Scale(BSID)scores were compared between two groups.Results After 3 days of treatment,there were no significant differences in aEEG score and NSE levels between the two groups of HIE newborns with mild disease(P>0.05).In the children with moderate and severe HIE,the aEEG score and NSE levels in the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).In the observation group,aEEG scores and NSE levels were significantly lower in newborns with moderate and severe HIE at treatment time<6 h compared with treatment start time≥6 h,with significant differences(P<0.05).The scores of psychological development index(MDI)of the two groups after treatment time<6 h were significantly higher than those of≥6 h,and in the same period of time,the MDI scores of the observation group were significantly higher than those of the control group,with significant differences(P<0.05).The psychomotor development index(PDI)score of observation group was significantly higher than that of control group,with significant difference(P<0.05).In the same group,there was no statistical significance in PDI scores of<6 h and≥6 h after treatment(P>0.05).Conclusion The optimal treatment time for newborns with HIE is within 6 hours of onset.In addition,the combination of mild hypothermia and erythropoietin in

关 键 词：缺氧缺血性脑病 新生儿 亚低温治疗 治疗时间 AEEG NSE 

分 类 号：R742[医药卫生—神经病学与精神病学]