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目的 :探讨促红细胞生成素(EPO)联合亚低温治疗重度新生儿缺氧缺血性脑病(HIE)的临床效果及对患儿1年发育的影响。方法 :将82例HIE患儿随机分为对照组与观察组各41例。对照组采用亚低温治疗,观察组在此基础上加用EPO治疗,比较两组患儿治疗前后血神经元特异性烯醇化酶(NSE)、S100B蛋白(S-100B)、神经行为能力评分(NBNA)、神经学评分、发育评分的变化。结果 :(1)治疗24h、72h、1周,两组NSE、S-100B、神经学评分均降低,观察组各时间点降低幅度高于对照组。(2)治疗1、2、4周,两组NBNA评分均上升,观察组上升幅度高于对照组。(3)观察组3月龄、6月龄、12月龄患儿MDI、PDI评分均高于对照组,与同组3月龄比较,两组6月龄、12月龄MDI、PDI评分均上升。结论 :采用EPO联合亚低温治疗重度HIE患儿,神经保护作用显著,且可改善患儿神经功能,促进其发育。
Objective: To investigate the clinical effect of erythropoietin (EPO) combined with mild hypothermia in the treatment of severe neonatal hypoxic-ischemic encephalopathy (HIE) and its effect on the development of children for one year. Methods: 82 cases of HIE were randomly divided into control group and observation group, 41 cases each. The control group was treated with mild hypothermia. The observation group was treated with EPO. The levels of neuron-specific enolase (NSE), S100B protein (S-100B), neurobehavioral score NBNA), neurological score, change in developmental score. Results: (1) Neurological scores of NSE, S-100B decreased in both groups at 24 h, 72 h, and 1 week after treatment, and the decrease in observation group was higher than that in control group at each time point. (2) After 1, 2 and 4 weeks of treatment, the NBNA scores of both groups increased, and the increase rate of observation group was higher than that of control group. (3) The MDI and PDI scores in 3-month, 6-month and 12-month old children in the observation group were higher than those in the control group. Compared with the 3-month-old children in the same group, the 6-month and 12-month MDI and PDI scores rise. Conclusion: EPO combined with mild hypothermia in children with severe HIE has significant neuroprotective effect and can improve children’s neurological function and promote their development.