胞二磷胆碱联合重组人促红素治疗新生儿缺氧缺血性脑病的临床疗效及其对患儿神经功能的影响

背景 新生儿缺氧缺血性脑病(HIE)具有较高的病死率、致残率,临床主要采用胞二磷胆碱治疗新生儿HIE并取得了一定疗效,但该药物不良反应较多,一定程度上影响了临床疗效,因此探寻新的治疗方式对提高新生儿HIE的治疗效果具有重要的临床意义.目的 探讨胞二磷胆碱联合重组人促红素治疗新生儿HIE的临床疗效及其对患儿神经功能的影响...

Effect of Citicoline Combined with Recombinant Human Erythropoietin in the Treatment of Neonatal Hypoxic-ischemic Encephalopathy and the Impact on Neurological Function of Children

Background Neonatal hypoxic-ischemic encephalopathy(HIE)has a high mortality and disability rate,which is mainly treated by citicoline and has achieved certain curative effect,but there are many adverse reactions of citicoline,which affected the clinical efficacy to some extent.Therefore,it is of great clinical significance to explore new treatment methods to improve the therapeutic effect of neonatal HIE.Objective To investigate the clinical effect of citicoline combined with recombinant human erythropoietin in the treatment of neonatal HIE and the impact on neurological function of children.Methods A total of 120 HIE children were selected in Paediatrics Departemnt,Wuhan Third Hospital from January 2019 to January 2021,and they were divided into control group(n=60)and observation group(n=60)according to random number table method.All children were given routine symptomatic support treatment,on this basis,children in control group were treated with citicoline injection,children in observation group were treated with recombinant human erythropoietin injection based on control group,both groups were treated with 30 days.Clinical effect,original reflex,muscle tension and consciousness returned to normal time,Neonatal Behavioral Neurological Assessment Scale(NBNA)score before treatment and at 10,20,30 days after treatment,serum levels of Tau protein,neuron specific enolase(NSE)were compared between the two groups,incidence of adverse reactions were observed between the two groups.Results Clinical effect in observation group was better than that of control group(P<0.05).Original reflex,muscle tension and consciousness returned to normal time in observation group were shorter than those of control group(P<0.05).There was statistically significant interaction between time and treatment method on NBNA score(P<0.05);main effects of time and treatment method were statistically significant on NBNA score(P<0.05).NBNA score at 10,20,30 days after treatment in observation group was higher than that of control group(P<0.05).In the two groups,NBNA score at 10,20,30 days after treatment was higher than that before treatment,respectively;NBNA score at 20,30 days after treatment was higher than that at 10 days after treatment,repectively;NBNA score at 30 days after treatment was higher than that at 20 days after treatment(P<0.05).Serum levels of Tau protein,NSE at 30 days after treatment in observation group were lower than those of control group(P<0.05).Serum levels of Tau protein,NSE at 30 days after treatment in the two group were lower than those before treatment(P<0.05).No serious adverse reactions occurred in the two groups during treatment.Conclusion Citicoline combined with recombinant human erythropoietin have an exact clinical effect in the treatment of neonatal HIE,which can obviously improve neurological function of children,reduce neurological function injury,promote the rapid recovery of diseases,and with high safety.