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目的探讨神经节苷脂对缺氧缺血性脑病(HIE)新生儿的治疗作用及其机制。方法 59例HIE新生儿患儿,单唾液酸四己糖神经节苷脂治疗组(干预组)31例(男性16例,女性15例),平均胎龄(38.5±2.5)周,其中轻度HIE10例,中度HIE15例,重度HIE6例。对照组28例(男性15例,女性13例),平均胎龄(38.1±2.7)周,其中轻度HIE13例,中度HIE11例,重度HIE4例。治疗组在综合治疗基础上加用单唾液酸四己糖神经节苷脂20mg/次加入100g/L葡萄糖溶液30～50mL静脉滴注;对照组28例仅综合治疗。2组均在给药后1、3、6d采集外周静脉血,采用放射免疫分析法检测其血清白细胞介素(IL)-10水平、酶联免疫吸附法测定肿瘤坏死因子(TNF)-α水平,3月龄时门诊随访,进行神经精神运动发育商测定。采用SPSS11.0软件进行组间t检验。结果与对照组比较,干预组治疗第1天,其血清IL-10、TNF-α水平差异无统计学意义(t=0.35,0.64,P>0.05);第3、6天其血清IL-10、TNF-α水平明显低于对照组:第3天(t=5.34,5.2,P均<0.01);第6天(t=2.92,3.2,P<0.05)。3月龄时,2组患儿发育障碍发生率差异有统计学意义(χ2=19.06,P<0.05)。结论神经节苷脂在缺氧缺血性脑损伤中可保护脑细胞改善预后,并可促进神经功能的恢复。
Objective To investigate the therapeutic effect of gangliosides on neonates with hypoxic-ischemic encephalopathy (HIE) and its mechanism. Methods Totally 59 cases of neonates with HIE were treated with monosialotetrahexosyl ganglioside (intervention group), 31 (16 males and 15 females) with an average gestational age of 38.5 ± 2.5 weeks, of which mild 10 cases of HIE, moderate HIE15 cases, severe HIE6 cases. The control group of 28 patients (15 males and 13 females), mean gestational age (38.1 ± 2.7) weeks, of which mild HIE in 13 cases, 11 cases of moderate HIE, severe HIE4 cases. The treatment group was treated with monosialotetrahexosyl ganglioside 20mg / time on the basis of comprehensive treatment plus 100g / L glucose solution 30 ~ 50mL intravenous drip; control group of 28 patients were treated only. Peripheral venous blood was collected at 1, 3 and 6 days after administration, and the level of serum interleukin (IL) -10 was detected by radioimmunoassay. The levels of tumor necrosis factor-α (TNF-α) were measured by enzyme-linked immunosorbent assay , 3-month-old clinic follow-up, neuropsychiatric exercise developers measured. SPSS11.0 software was used for t-test between groups. Results Compared with the control group, the levels of IL-10 and TNF-α in the intervention group had no significant difference on the first day (t = 0.35,0.64, P> 0.05) (T = 5.34,5.2, P <0.01). On the 6th day (t = 2.92,3.2, P <0.05), the level of TNF-α was significantly lower than that of the control group. At 3 months of age, the incidence of developmental disorders in both groups was statistically different (χ2 = 19.06, P <0.05). Conclusion Gangliosides can protect brain cells in hypoxic-ischemic brain damage and improve prognosis, and can promote the recovery of nerve function.