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目的:研究脑苷肌肽对高原地区新生儿缺氧缺血脑病患者疗效及其对脑脊液中可溶性髓样细胞触发受体-1、胰岛素样生长因子-1、髓鞘碱性蛋白水平的影响。方法:选取2011年2月~2014年6月笔者所在医院儿科收治的新生儿缺氧缺血脑病患者114例,随机均分为脑苷肌肽治疗组和常规治疗组,另选30例健康新生儿作为对照;常规治疗组给予常规基础治疗,脑苷肌肽治疗组患者在基础治疗上加用脑苷肌肽注射液,疗程为2周,每日1次,每次10ml静脉滴注。治疗后考察临床疗效和患者脑脊液中可溶性髓样细胞触发受体-1、胰岛素样生长因子-1、髓鞘碱性蛋白的水平变化。结果:与健康对照组比较,中、重度新生儿缺氧缺血脑病患儿胰岛素样生长因子-1水平显著下调(P<0.05),可溶性髓样细胞触发受体-1、髓鞘碱性蛋白水平显著上调(P<0.05);与轻度组比较,中、重度组患者胰岛素样生长因子-1浓度减小,可溶性髓样细胞触发受体-1和髓鞘碱性蛋白浓度增加,差异均具有统计学意义(P<0.05);与常规治疗组比较,脑苷肌肽治疗后,有效率从70.18%升高到89.47%,脑脊液中胰岛素样生长因子-1含量由41.15±3.06ng/ml增大到52.04±3.53ng/ml,可溶性髓样细胞触发受体-1从95.01±9.63ng/ml下降为75.38±8.46ng/ml、髓鞘碱性蛋白含量从17.55±6.07ng/ml减小为12.01±5.16ng/ml,差异比较均具有统计学意义(P<0.05)。结论:脑脊液中可溶性髓样细胞触发受体-1、胰岛素样生长因子-1、髓鞘碱性蛋白水平的变化与疾病的严重程度相关,提示可作为新生儿缺氧缺血脑病早期辅助诊断的可靠指标;脑苷肌肽对高原地区新生儿缺氧缺血脑病疗效显著,可减轻脑细胞损伤,值得临床推广使用。
Objective: To investigate the effect of cerebroside on neonatal hypoxic-ischemic encephalopathy in the plateau and its effect on soluble myeloid cell-triggered receptor-1, insulin-like growth factor-1 and myelin basic protein in cerebrospinal fluid. Methods: A total of 114 neonates with hypoxic-ischemic encephalopathy admitted to our hospital from February 2011 to June 2014 were randomly divided into three groups: encephalitis-carnitine treatment group and conventional treatment group, and another 30 healthy newborn As a control; conventional treatment group given conventional basic treatment, brain glycosides in patients with glycosides treatment group on the basis of treatment with brain glycosaminoglycan injection, treatment for 2 weeks, once daily, each 10ml intravenous infusion. After treatment, clinical efficacy and soluble myeloid cells in patients with cerebrospinal fluid trigger receptor-1, insulin-like growth factor-1, myelin basic protein level changes. Results: Compared with the healthy control group, the level of insulin - like growth factor - 1 in children with hypoxia - ischemic encephalopathy was significantly decreased (P <0.05), soluble myeloid cells triggered receptor - 1, myelin basic protein (P <0.05). Compared with the mild group, the concentration of insulin-like growth factor-1 in the moderate and severe groups decreased and the concentration of soluble myeloid cells-triggered receptor-1 and myelin basic protein increased (P <0.05). Compared with the conventional treatment group, the effective rate increased from 70.18% to 89.47% after treatment with cerebroside, the content of insulin-like growth factor-1 in cerebrospinal fluid increased from 41.15 ± 3.06ng / ml To 52.04 ± 3.53ng / ml, soluble myeloid cell trigger receptor-1 decreased from 95.01 ± 9.63ng / ml to 75.38 ± 8.46ng / ml and myelin basic protein decreased from 17.55 ± 6.07ng / ml to 12.01 ± 5.16ng / ml, the differences were statistically significant (P <0.05). CONCLUSION: The changes of soluble myeloid cells triggering receptor-1, insulin-like growth factor-1 and myelin basic protein in cerebrospinal fluid correlate with the severity of the disease, which may be used as an early auxiliary diagnosis for neonatal hypoxic-ischemic encephalopathy Reliable indicators; cerebroside glycosides on the plateau neonatal hypoxic-ischemic encephalopathy significant effect, can reduce brain cell damage, it is worth promoting the use of the clinic.