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目的:研究静脉应用大剂量白蛋白对重症新生儿缺氧缺血性脑病(hypoxicischemicencephalopathy,HIE)的疗效。方法:选择重症HIE患儿76例,分为2组:大剂量白蛋白治疗组48例,静脉滴注人血白蛋白2g/(kg·d),连续3～5d;常规治疗(对照)组28例,给予常规治疗。在日龄7,14,25～30d连续检查3次新生儿神经行为(neonatalbehavioralneurologicalassessment,NBNA)评分;3,6个月时用《儿心0～4岁精神发育量表》测定发育商。结果:大剂量白蛋白可显著性提高重度HIE新生儿NBNA评分(白蛋白组:25.33±3.19～35.91±3.08;常规组:26.01±3.47～32.11±3.20),差异有显著性意义(t=2.90～2.98,P<0.01);亦升高3,6个月时发育商(白蛋白组:94.01±10.81,93.10±9.07;常规组:80.01±12.33,84.91±10.19),差异有显著性意义(t=2.49,1.84,P<0.01)。结论:静脉滴注大剂量人血白蛋白可明显改善重度HIE新生儿的神经行为与及发育商。
Objective: To study the curative effect of intravenous high-dose albumin on severe neonatal hypoxic-ischemic encephalopathy (HIE). Methods: Seventy-six children with severe HIE were divided into two groups: 48 patients in the high-dose albumin group and 2g / (kg · d) intravenous infusion of human serum albumin for 3 ~ 5 days. 28 cases, given conventional treatment. Neonatalbehavioralneurologicalassessment (NBNA) score was examined three times in succession on days 7,14,25 ~ 30d, and developmental quotient was measured at 3,6months. Results: High-dose albumin significantly increased the NBNA score of neonates with severe HIE (albumin: 25.33 ± 3.19 ~ 35.91 ± 3.08; conventional group: 26.01 ± 3.47 ~ 32.11 ± 3.20), the difference was significant (t = 2.90 ~ 2.98, P <0.01), but also increased at 3 and 6 months (albumin: 94.01 ± 10.81 and 93.10 ± 9.07; conventional group: 80.01 ± 12.33 and 84.91 ± 10.19, respectively) t = 2.49, 1.84, P <0.01). Conclusion: Intravenous infusion of high-dose human serum albumin can significantly improve the neurobehavioral and developmental traits of neonates with severe HIE.