神经节苷脂辅助高压氧治疗小儿病毒性脑炎的临床研究  

Clinical study of ganglioside assisted hyperbaric oxygen therapy for pediatric viral encephalitis

作　　者：米艺果 马阳 Mi Yiguo;Ma Yang(Deept of Pediatrics,The First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,China)

机构地区：[1]南阳医学高等专科学校附属中医院儿科,河南南阳473000

出　　处：《青岛医药卫生》2024年第3期219-223,共5页Qingdao Medical Journal

基　　金：河南省医学科技攻关项目(LHGJ202001235):基于miR-133b/ELAVL1分子轴缓解小儿病毒性心肌炎的作用机制研究。

摘　　要：目的 观察神经节苷脂辅助高压氧治疗小儿病毒性脑炎的临床效果。方法 本研究为前瞻性研究,研究对象为南阳医学高等专科学校附属中医院2022年6月~2023年10月期间收治的病毒性脑炎患儿中随机抽取92例,应用计算机随机分组法将其分别列为高压氧组(46例)和联合组(46例),高压氧组实施高压氧治疗,联合组采用神经节苷脂辅助高压氧治疗,比较两组患儿的血清选择素,神经功能指标,免疫指标,认知功能及治疗安全性。结果 在不同治疗方案下,联合组的L-选择素(CD62L)、P选择素(CD62P)分别为(1045.23±100.29)ng/L、(30.23±5.33)ng/L,均低于高压氧组[(1109.25±100.37)ng/L、(33.45±3.41)ng/L];联合组的神经元轴突轻链(NF-L)、神经元特异性烯醇化酶(NSE)、中枢神经特异蛋白(S100β)分别为(1029.65±100.41)μg/L、(35.62±5.23)μg/L、(10.41±2.25)pg/mL,均低于高压氧组[(1125.75±100.78)μg/L、(38.29±5.31)μg/L、(12.31±3.23)pg/mL];联合组的T淋巴细胞亚群CD3+、CD4+、CD4+/CD8+分别为(67.26±10.35)%、(70.33±10.24)%、(1.88±0.26),均高于高压氧组[(62.33±10.29)%、(65.45±10.29)%、(1.31±0.52)];联合组的简易精神状态量表(MMSE)、蒙特利尔认知评估量表(MoCA)评分分别为(27.36±5.28)分、(27.25±5.31)分,均高于常规组[(24.41±5.33)分、(24.35±5.22)分],差异均具有统计学意义(P<0.05)。联合组的不良事件发生率6.52%(3/46)略高于高压氧组2.17%(1/46),差异无统计学意义(P>0.05)。结论 神经节苷脂辅助高压氧能降低病毒性脑炎患儿的血清选择素水平,对减轻神经损伤、增强免疫功能、改善认知功能均有积极意义;联合应用神经节苷脂未明显增加不良事件发生风险,治疗安全性较高。Objective Observation of the clinical effect of ganglioside assisted hyperbaric oxygen therapy on pediatric viral encephalitis.Methods This study is a prospective study.The study subjects will be randomly selected from 92 children with viral encephalitis admitted to our hospi-tal from June 2022 to October 2023.They will be divided into a hyperbaric oxygen group(46 ca-ses)and a combination group(46 cases)using computer random grouping method.The hyper-baric oxygen group will receive hyperbaric oxygen treatment,while the combination group will receive ganglioside assisted hyperbaric oxygen treatment.The serum selectin,neurological func-tion indicators,immune indicators,cognitive function,and treatment safety of the two groups of children will be compared.Results Under different treatment regimens,the CD62L and CD62P in the combination group were(1045.23±100.29)ng/L and(30.23±5.33)ng/L,lower than the hyperbaric oxygen group[(1109.25±100.37)ng/L and(33.45±3.41)ng/L];The level of NF-L,NSE,S100βin the combination group were(1029.65±100.41)μg/L,(35.62±5.23)μg/L,(10.41±2.25)pg/mL,all lower than those in the hyperbaric oxygen group[(1125.75±100.78)μg/L,(38.29±5.31)μg/L,(12.31±3.23)pg/mL];The levels of CD^(3+),CD^(4+),and CD^(4+)/CD^(8+)in the combination group were(67.26±10.35)%,(70.33±10.24)%,and(1.88±0.26),higher than the hyperbaric oxygen group[(62.33±10.29)%,(65.45±10.29)%,and(1.31±0.52)];The MMSE and MoCA scores of the combination group were(27.36±5.28)points and(27.25±5.31)points,higher than the conventional group[(24.41±5.33)points and(24.35±5.22)points](P<0.05).The incidence of adverse events in the combination group was 6.52%(3/46),slightly higher than the hyperbaric oxygen group 2.17%(1/46)(P>0.05).Conclusion Ganglioside assisted hyperbaric oxygen therapy can reduce serum selectin levels in children with viral encephalitis,which has positive significance in reducing nerve damage,enhancing immune function,and improving cognitive function;The combined use of gangliosides did not significan

关 键 词：小儿病毒性脑炎 神经节苷脂 高压氧 神经功能 认知功能 

分 类 号：R725.1[医药卫生—儿科]