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目的探讨选择性头部亚低温治疗新生儿缺氧缺血性脑病(HIE)对血清神经元特异性烯醇化酶(NSE)及新生儿行为神经评分(NBNA)的影响。方法选择2012年12月入住濮阳市人民医院新生儿重症监护病房的中、重度HIE患儿,随机分为亚低温治疗组和常规治疗组,分别监测治疗开始后0、24、48、72 h外周血清NSE含量;比较两组患儿生后7、14、28 d新生儿NBNA评分。结果在治疗后观察组0、24、48、72 h NSE水平分别为(20.32±6.75)ng/L、(23.26±2.89)ng/L、(38.12±7.96)ng/L、(31.91±10.14)ng/L;对照组分别为(19.76±3.82)ng/L、(24.41±5.91)ng/L、(48.67±9.96)ng/L、(41.78±3.46)ng/L;两组血清NSE含量在0、24 h比较差异无统计学意义(P>0.05),在48、72 h亚低温治疗组NSE明显低于常规治疗组,差异有统计学意义(P<0.05)。生后7 d,两组患儿NBNA评分比较,差异无统计学意义(P>0.05),生后14、28 d NBNA评分比较,亚低温治疗组明显高于常规治疗组,差异有统计学意义(P<0.05)。结论选择性头部亚低温治疗能有效降低NSE水平,具有脑保护作用,对改善患儿预后有积极作用。
Objective To investigate the effects of selective head mild hypothermia on serum neuron-specific enolase (NSE) and neonatal behavioral neurological score (NBNA) in neonates with hypoxic-ischemic encephalopathy (HIE). Methods The children with moderate and severe HIE who admitted to the Neonatal Intensive Care Unit of Puyang People’s Hospital in December 2012 were randomly divided into mild hypothermia treatment group and conventional treatment group. The peripheral blood samples at 0, 24, 48 and 72 h after treatment were monitored Serum NSE levels; neonatal NBNA scores were compared between the two groups after birth 7,14,28 d. Results The levels of NSE at 0, 24, 48 and 72 h after treatment were (20.32 ± 6.75) ng / L, (23.26 ± 2.89) ng / L and (38.12 ± 7.96) ng / L and (31.91 ± 10.14) (19.76 ± 3.82) ng / L, (24.41 ± 5.91) ng / L, (48.67 ± 9.96) ng / L and (41.78 ± 3.46) ng / L respectively) .The levels of serum NSE in the two groups were There was no significant difference at 0,24 h (P> 0.05). The NSE of the hypothermia group at 48 and 72 h was significantly lower than that of the conventional treatment group (P <0.05). There was no significant difference in NBNA score between the two groups at 7 days after birth (P> 0.05). NBNA score at 14 and 28 days after birth in the mild hypothermia group was significantly higher than that in the conventional treatment group, the difference was statistically significant (P <0.05). Conclusion Selective head mild hypothermia treatment can effectively reduce the level of NSE, with a protective effect on the brain, to improve the prognosis of children have a positive effect.