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目的:探讨鼠神经生长因子对新生儿缺氧缺血性脑病(HIE)患儿血清神经肽Y(NPY)和神经元特异性烯醇化酶(NSE)水平的影响及疗效观察。方法:采用随机数字表法将70例新生儿HIE患儿分成观察组和对照组。两组患儿均予以吸氧、控制颅内压、血压和血糖,抗惊厥、保持水电解质平衡等常规治疗。观察组患儿加用鼠神经生长因子20μg,im,qd。对照组患儿加用胞磷胆碱注射液100 mg,ivd,qd,均连用10~14 d。观察两组患儿治疗前后血清NPY和NSE水平变化,比较两组疗效及药品不良反应,随访1年内神经系统后遗症的发生率。结果:治疗2周后,两组血清NPY和NSE水平较前均明显下降(P<0.05和P<0.01),且观察组下降幅度明显大于对照组(P<0.05);观察组临床总有效率为94.28%,明显高于对照组的68.57%(P<0.01),两组患儿治疗中未出现明显药品不良反应。随访观察1年,观察组后遗症的发生率明显低于对照组(P<0.05)。结论:鼠神经生长因子治疗新生儿HIE的疗效肯定,安全性好,可促进受损神经元细胞的修复,减少神经系统后遗症的发生率,其作用与降低血清NPY和NSE水平密切相关。
Objective: To investigate the effect of nerve growth factor (NGF) on serum neuropeptide Y (NPY) and neuron specific enolase (NSE) levels in neonates with hypoxic-ischemic encephalopathy (HIE) and their clinical effects. Methods: 70 neonates with HIE were divided into observation group and control group by random number table method. Two groups of children were given oxygen, control of intracranial pressure, blood pressure and blood glucose, anticonvulsant, to maintain water and electrolyte balance and other conventional treatment. Observation group children with mouse nerve growth factor 20μg, im, qd. Children in the control group plus citicoline injection 100 mg, ivd, qd, were used for 10 ~ 14 d. The changes of serum NPY and NSE levels in both groups before and after treatment were observed. The curative effect and adverse drug reactions of the two groups were compared. The incidence of neurological sequelae within one year after the visit was compared. Results: After 2 weeks of treatment, the levels of serum NPY and NSE in both groups were significantly lower than those in the previous two groups (P <0.05 and P <0.01), and the decreasing rates in the observation group were significantly greater than those in the control group (P <0.05) Was 94.28%, which was significantly higher than that of the control group (68.57%, P <0.01). There was no apparent adverse drug reaction in the two groups. Followed up for 1 year, the incidence of sequelae in the observation group was significantly lower than that in the control group (P <0.05). Conclusion: The therapeutic effect of NGF on neonates with HIE is affirmative and safe. It can promote the repair of injured neurons and reduce the incidence of neurological sequelae, which is closely related to the reduction of serum NPY and NSE levels.