亚低温联合神经节苷脂对新生儿缺血缺氧性脑病合并窒息的功能恢复及血浆神经肽Y的影响
|
摘要
目的探究亚低温联合神经节苷脂对新生儿缺血缺氧性脑病(HIE)合并窒息的功能恢复及血浆神经肽Y(NPY)的影响,为患儿的临床治疗提供参考。方法回顾性分析该院2015年6月-2017年6月收治的HIE合并窒息患儿98例作为研究对象。患儿根据治疗方式的不同平均分为观察组和对照组,每组各49例,观察组患儿在早期亚低温治疗的基础上联合神经节苷脂进行治疗,对照组患儿仅采取早期亚低温治疗,分析两组患儿治疗后的临床疗效、神经功能、血清糖分解烯醇酶(NSE)、S-100β蛋白、血浆NPY水平以及预后情况。结果观察组患儿在经过治疗后,治疗的总有效率为91.84%,明显高于对照组的71.43%(P<0.05),患儿NSE水平、S-100β水平、NPY水平明显低于对照组(P<0.0.5),并且观察组患儿神经功能评分明显高于对照组,而意识恢复时间、反射恢复时间、肌张力恢复时间明显少于对照组(P<0.05),患儿在经过治疗后并发症的发生率为22.45%,明显低于对照组的51.02%(P<0.05)。结论亚低温联合神经节苷脂能够有效降低患儿NPY水平,促进神经功能恢复,缩短临床体征恢复时间。
Objective To explore the effect of mild hypothermia combined with ganglioside on functional recovery and plasma neuropeptide Y(NPY) in neonates with hypoxic-ischemic encephalopathy(HIE) complicated with asphyxia,provide a reference for clinical treatment.Methods Ninety-eight neonates with HIE complicated with asphyxia treated in People's Hospital of Wenjiang District from June 2015 to June 2017 were analyzed retrospectively,all the neonates were divided into observation group and control group according to different treatment methods,49 neonates in each group.The neonates in observation group were treated by early mild hypothermia combined with ganglioside,and the neonates in control group were treated by early mild hypothermia.The clinical effects,neurological function,serum neuronspecific enolase(NSE),S-100β protein,plasma NPY levels,and prognosis in the two groups were analyzed.Results After treatment,the total effective rate of treatment in observation group was 91.84%,which was statistically significantly higher than that in control group(71.43%)(P<0.05); the levels of NSE,S-100β protein,and plasma NPY in observation group were statistically significantly lower than those in control group(P<0.05); neurological function score in observation group was statistically significantly higher than that in control group; the recovery time of consciousness,reflex recovery time,and recovery time of muscular tension in observation group was statistically significantly shorter than that in control group(P < 0.05); the incidence rate of complications after treatment in observation group was 22.45%,which was statistically significantly lower than that in control group(51.02%)(P<0.05).Conclusion Mild hypothermia combined with ganglioside can effectively reduce NPY level in children,promote recovery of neurological function,and shorten recovery time of clinical signs.
Objective To explore the effect of mild hypothermia combined with ganglioside on functional recovery and plasma neuropeptide Y(NPY) in neonates with hypoxic-ischemic encephalopathy(HIE) complicated with asphyxia,provide a reference for clinical treatment.Methods Ninety-eight neonates with HIE complicated with asphyxia treated in People's Hospital of Wenjiang District from June 2015 to June 2017 were analyzed retrospectively,all the neonates were divided into observation group and control group according to different treatment methods,49 neonates in each group.The neonates in observation group were treated by early mild hypothermia combined with ganglioside,and the neonates in control group were treated by early mild hypothermia.The clinical effects,neurological function,serum neuronspecific enolase(NSE),S-100β protein,plasma NPY levels,and prognosis in the two groups were analyzed.Results After treatment,the total effective rate of treatment in observation group was 91.84%,which was statistically significantly higher than that in control group(71.43%)(P<0.05); the levels of NSE,S-100β protein,and plasma NPY in observation group were statistically significantly lower than those in control group(P<0.05); neurological function score in observation group was statistically significantly higher than that in control group; the recovery time of consciousness,reflex recovery time,and recovery time of muscular tension in observation group was statistically significantly shorter than that in control group(P < 0.05); the incidence rate of complications after treatment in observation group was 22.45%,which was statistically significantly lower than that in control group(51.02%)(P<0.05).Conclusion Mild hypothermia combined with ganglioside can effectively reduce NPY level in children,promote recovery of neurological function,and shorten recovery time of clinical signs.
引文
[1]杜立树,平龙玉,张曼俐,等.缺血缺氧性脑病新生儿免疫功能的变化及临床意义分析[J].中国实验诊断学,2015,32(3):395-398.
[2]朱娟,沙米村,乔继冰,等.高压氧对缺血缺氧性脑病新生儿IL-1β、IL-6、TNF-α、Hcy、hs-CRP及其远期预后的影响[J].广东医学,2016,37(20):3092-3094.
[3]吴荣,杜晓霞,何静杰,等.缺血缺氧性脑病91例康复治疗临床分析[J].北京医学,2017,39(5):502-505.
[4]肖玉琴,王庆云.成人缺血缺氧性脑病预后的相关因素分析[J].中国实用神经疾病杂志,2017,20(8):75-76.
[5]张志涛,陈彬,白哗,等.缺血缺氧性脑病模型幼鼠脑损伤区神经元电生理特性分析[J].中国医药,2015,10(4):496-500.
[6]孙妍,李居龙,王竹颖,等.单唾液酸四己糖神经节苷脂对新生儿窒息并发缺血缺氧性脑病的疗效[J].解放军医药杂志,2015,15(11):99-101,105.
[7]杨青美.综合疗程治疗干预对新生儿缺血缺氧性脑病的康复影响[J].川北医学院学报,2016,31(3):373-376.
[8]牟志芳,董跃福,李勇,等.亚低温对心肺复苏术后缺血缺氧性脑病的影响[J].中国实用神经疾病杂志,2014,25(24):73-74.
[9]巩博,李文放.脂肪间充质干细胞治疗缺血缺氧性脑病的研究进展[J].第二军医大学学报,2017,38(5):646-651.
[10]蔡丽丹,钟敏,李伟,等.血清TLR4表达水平与缺血缺氧性脑病急性期脑损伤程度的关系[J].中国急救复苏与灾害医学杂志,2017,12(9):835-837.
[11]宋克义,颜秀侠,韩若东,等.脑组织氧代谢监测在心肺复苏后缺血缺氧性脑病患者中的临床研究[J].中华全科医学,2014,12(8):1224-1226.
[12]王枫涛,江成平.神经节苷脂对新生儿缺血缺氧性脑病的疗效及对血清肿瘤坏死因子-α及白介素-6的影响[J].神经损伤与功能重建,2015,43(4):283-284,294.
[13]Schnaar RL,Gerardy-Schahn R,Hildebrandt H,et al.Sialic acids in the brain:gangliosides and polysialic acid in nervous system development,stability,disease,and regeneration[J].Physiol Rev,2014,94(2):461-518.
[14]马世尧,王清枫.单唾液酸四己糖神经节苷脂治疗新生儿窒息合并缺血缺氧性脑病的应用效果观察[J].中国妇幼保健,2017,32(10):2114-2115.
[15]张金剑.神经节苷脂治疗新生儿缺氧缺血性脑病36例[J].中国药业,2014,23(11):146-147.
[16]娄玉霞.单唾液酸神经节苷脂注射液在新生儿缺氧缺血性脑病治疗中的临床价值[J].现代预防医学,2014,127(4):635-637.
[17]王玉梅,郭银谋,袁向东,等.神经节苷脂结合高压氧对新生儿缺氧缺血性脑病的治疗效果[J].中国妇幼保健,2017,32(7):1490-1492.
[18]曾立军,符茵,陈泳涛,等.亚低温治疗中重度新生儿缺氧缺血性脑病内环境的变化[J].中国妇幼保健,2016,31(23):5056-5058.
[2]朱娟,沙米村,乔继冰,等.高压氧对缺血缺氧性脑病新生儿IL-1β、IL-6、TNF-α、Hcy、hs-CRP及其远期预后的影响[J].广东医学,2016,37(20):3092-3094.
[3]吴荣,杜晓霞,何静杰,等.缺血缺氧性脑病91例康复治疗临床分析[J].北京医学,2017,39(5):502-505.
[4]肖玉琴,王庆云.成人缺血缺氧性脑病预后的相关因素分析[J].中国实用神经疾病杂志,2017,20(8):75-76.
[5]张志涛,陈彬,白哗,等.缺血缺氧性脑病模型幼鼠脑损伤区神经元电生理特性分析[J].中国医药,2015,10(4):496-500.
[6]孙妍,李居龙,王竹颖,等.单唾液酸四己糖神经节苷脂对新生儿窒息并发缺血缺氧性脑病的疗效[J].解放军医药杂志,2015,15(11):99-101,105.
[7]杨青美.综合疗程治疗干预对新生儿缺血缺氧性脑病的康复影响[J].川北医学院学报,2016,31(3):373-376.
[8]牟志芳,董跃福,李勇,等.亚低温对心肺复苏术后缺血缺氧性脑病的影响[J].中国实用神经疾病杂志,2014,25(24):73-74.
[9]巩博,李文放.脂肪间充质干细胞治疗缺血缺氧性脑病的研究进展[J].第二军医大学学报,2017,38(5):646-651.
[10]蔡丽丹,钟敏,李伟,等.血清TLR4表达水平与缺血缺氧性脑病急性期脑损伤程度的关系[J].中国急救复苏与灾害医学杂志,2017,12(9):835-837.
[11]宋克义,颜秀侠,韩若东,等.脑组织氧代谢监测在心肺复苏后缺血缺氧性脑病患者中的临床研究[J].中华全科医学,2014,12(8):1224-1226.
[12]王枫涛,江成平.神经节苷脂对新生儿缺血缺氧性脑病的疗效及对血清肿瘤坏死因子-α及白介素-6的影响[J].神经损伤与功能重建,2015,43(4):283-284,294.
[13]Schnaar RL,Gerardy-Schahn R,Hildebrandt H,et al.Sialic acids in the brain:gangliosides and polysialic acid in nervous system development,stability,disease,and regeneration[J].Physiol Rev,2014,94(2):461-518.
[14]马世尧,王清枫.单唾液酸四己糖神经节苷脂治疗新生儿窒息合并缺血缺氧性脑病的应用效果观察[J].中国妇幼保健,2017,32(10):2114-2115.
[15]张金剑.神经节苷脂治疗新生儿缺氧缺血性脑病36例[J].中国药业,2014,23(11):146-147.
[16]娄玉霞.单唾液酸神经节苷脂注射液在新生儿缺氧缺血性脑病治疗中的临床价值[J].现代预防医学,2014,127(4):635-637.
[17]王玉梅,郭银谋,袁向东,等.神经节苷脂结合高压氧对新生儿缺氧缺血性脑病的治疗效果[J].中国妇幼保健,2017,32(7):1490-1492.
[18]曾立军,符茵,陈泳涛,等.亚低温治疗中重度新生儿缺氧缺血性脑病内环境的变化[J].中国妇幼保健,2016,31(23):5056-5058.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |