鼠神经生长因子在缺氧缺血性脑病新生儿的干预疗效观察

目的 探讨鼠神经生长因子（mNGF）在减少缺氧缺血性脑病新生儿（HIE）血清NSE释放及保护神经功能的干预效果.方法 抽选89例中重度HIE患者,采用分层随机法分为对照组（n=44例）和观察组（n=45例）,两组均予以常规综合治疗,对照组在此基础上加胞二磷胆碱治疗,观察组加用mNGF治疗,比较两组患儿治疗后症状改善时间、行为神经评分（NBNA）、血清中NSE等生化指标的差异,治疗后随访1年,比较两组患儿智能发育商（DQ）的变化.结果 观察组患儿意识、肌张力、反射恢复及惊厥改善时间明显短于对照组（P＜0.05）.两组患儿治疗第1 ～3 d（28.44±2.36 vs.28.42±2.32）NBNA评分比较差异无统计学意义（P＞0.05）；观察组第4～6d（32.78±2.33 vs.30.01±2.35）、第7～ 10 d（37.23±2.01 vs.33.13±2.09）患儿NBNA评分明显高于对照组（P＜0.05）.治疗前两组患儿血清S-100B、NSE比较差异无统计学意义（P＞0.05）；治疗3d及7d后观察组患儿血清NSE分别为（17.31±2.11）、（12.39±1.77）,均明显低于对照组（20.83±2.31）、（14.93±1.83）,P＜0.05.治疗后随访1年,观察组患儿的DQ正常率（86.7％）明显高于对照组（61.4％）,P＜ 0.05.结论 mNGF治疗新生儿HIE,可明显减少患儿血清NSE的释放,保护神经功能,提高患儿智能发育商的正常率.

Mouse nerve growth factor for neonatal hypoxic-ischemic encephalopathy

Objective To explore the intervention effect of mouse nerve growth factor on reducing the release of serum NSE and neurological protection in the children with neonatal hypoxic-ischemic encephalopathy （HIE）.Method 89 patients with moderate to severe HIE was chosen,and then were randomly divided into a control group （n=44） and an observation group （n=45） with stratified method.Both groups were treated with conventional therapy; in addition,the control group administered brain protein citicoline,and the observation group took mNGF.The time of symptoms improvement,behavioral neurological score （NBNA）,serum NSE and so on were compared between the 2 groups.After 1 years＇ follow-up,smart developmental quotient （DQ） of the two groups were compared.Results The improvement times of awareness,muscle tone,reflex recovery,and seizures were significantly shorter in the observation group than in the control group （P ＜ 0.05）.Day 1-3 of the treatment,there was no statistical difference in NBNA score （28.44 ± 2.36 vs.28.42 ± 2.32） between the observation group and the control group（P ＞ 0.05）; but day 4-6 and 7-10,there were statistical differences （32.78 ± 2.33 vs.30.01 ± 2.35,37.23 ± 2.01 vs.33.13 ± 2.09,P ＜ 0.05）.Before the treatment,there were no statistical differences in serum S-100B and NSE between the 2 groups （P ＞ 0.05）;3 and 7 days after the treatment,the serum S-100B and NSE were （17.31 ± 2.11） and （12.39 ± 1.77） were in the observation group and were （20.83 ± 2.31）,（14.93 ± 1.83） in the control group,respectively,with statistical differences（P ＜ 0.05）.After the 1-year follow-up,DQ normal rate was statistically higher in the observation group than in the control group （86.7％ vs.61.4％,P ＜ 0.05）.Conclusion mNGF for neonatal hypoxic-ischemic encephalopathy can significantly reduce serum NSE release,protect nerve function,and improve the intellectual development of children＇s normal rate.