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【目的】探讨单唾液酸四己糖神经节苷脂(monosialotetrahxosy1 ganglioside,GM1)治疗新生儿缺氧缺血性脑病的疗效及对血清金属蛋白酶-9(matrix metalloproteinases-9,MMP-9)水平的影响。【方法】60例新生儿缺氧缺血性脑病患儿,随机分为GM1治疗组(GM1组)30例和常规治疗组(常规组)30例,并选取正常新生儿20例作为对照组。比较治疗前后两组CT检测值与新生儿行为神经评分;并比较治疗组及正常对照组分别在生后24 h内及药物治疗7 d后抽血检测血清MMP-9水平。【结果】1)治疗后CT检查值,两组与治疗前比较,差异有统计学意义(t=3.11,P<0.05);治疗一疗程时两组间比较,差异无统计学意义(t=1.24,P>0.05),出生后28 d GM1组明显高于常规组(t=3.57,P<0.05)。两组患儿治疗后一疗程、出生后28d NBNA评分较前有明显改善,且GM1治疗组优于常规组(t=2.01,P<0.05);2)GM1组其临床症状和体征改善明显优于常规组(P<0.01);3)GM1组与常规治疗组后血清浓度MMP-9较前明显降低,其中GM1组降低幅度明显高于常规组(P<0.01)。【结论】GM1在HIE患儿早期应用可稳定神经元细胞膜,减少细胞凋亡,从而减少MMP-9的释放,发挥神经保护作用。
【Objective】 To investigate the therapeutic effect of monosialotetrahxosy1 ganglioside (GM1) on neonatal hypoxic-ischemic encephalopathy and its effect on the expression of matrix metalloproteinases-9 (MMP-9) influences. 【Methods】 Sixty neonates with hypoxic-ischemic encephalopathy were randomly divided into three groups: GM1 group (30 cases) and routine group (30 cases), and 20 normal neonates were selected as control group. The CT values and neonatal neurobehavioral scores of the two groups before and after treatment were compared. The levels of serum MMP-9 in the treated group and the normal control group were compared within 24 hours after birth and 7 days after the drug treatment. [Results] 1) After treatment, the CT value of the two groups was significantly different from that before treatment (t = 3.11, P <0.05). There was no significant difference between the two groups in treatment duration (t = 1.24, P> 0.05). At 28 days after birth, GM1 group was significantly higher than the conventional group (t = 3.57, P <0.05). The NBNA score at 28th day after birth was significantly improved in both groups and the GM1 group was superior to the conventional group (t = 2.01, P <0.05); 2) The clinical symptoms and signs of GM1 group were significantly improved (P <0.01). 3) The serum concentration of MMP-9 in GM1 group and conventional treatment group was significantly lower than that in the conventional group (P <0.01), and the decrease in GM1 group was significantly higher than that in the conventional group (P <0.01). 【Conclusion】 Early application of GM1 in children with HIE can stabilize the cell membrane of neurons, reduce the apoptosis, reduce the release of MMP-9, and exert the neuroprotective effect.