神经节苷脂对早产儿脑白质损伤的临床疗效观察与分析

目的探讨神经节苷脂(GM1)在早产儿脑白质损伤治疗中的临床意义。 方法对入住北京大学第一医院新生儿ICU病房的早产儿于生后1周内常规行床旁头颅B超检查，将确诊为脑白质损伤(WMD)的89例患儿分为GM1治疗组及对照组。在积极治疗早产儿各项并发症的基础上，治疗组另给予GM1治疗，动态观察头颅B超的变化情况并进行随访。 结果在收治的356例早产儿中，确诊WMD的患儿89例，发生率为25%。第一疗程GM 1治疗后，经头颅B超的动态观察，治疗组的56例均较对照组好转，差异有显著性(P<0.05)。治疗组中有33例患儿追踪至生后6个月，头颅超声显示16例出现了脑室扩大，占48%；2例出现了明显的智力及运动发育落后，约占6%；5例表现为限局性的肌张力、运动异常及轻微的认知障碍，占15%。对照组中有10例患儿追踪至生后6个月，8例出现脑室扩大，占80%；3例出现了明显的智力及运动发育落后，占30%；2例出现了轻微的认知及行为障碍，占20%。 结论GM 1可减少脑白质软化及持续性病变的发生，改善预后。

The application of individualised immune-suppression and anticoagulant in therapy of RSA with ACA

AbstractObjectiveTo study on the clinical significance of GM 1 in treating the premature white matter damage. MethodsAll premature infants who were hospitalized in NICU received routine bedside cranial sonography detection before 1 week aged.Divide the confirmed patients into GM 1 treating group and control group.The treating group consisted of 56 cases;control group of 33 cases.On the basis of being positive treated complicating disease,the treating group also accepted the treatment of GM 1.Dynamically observe the changing of cranial sonography and follow up. ResultsOf 356 cases,89 were confirmed,and the proportion was 25%.After one course of treatment observe the recovery of cranial sonography.The treating group was better than the control group.The divergence had prominence.Thirty three cases of treating group were followed up to 6 month aged.Sixteen cases had ventriculus enlarging,covering 48%;2 cases of obvious locomotion and intelligence hypoevolutism;5 cases of localized abnormality of muscular tension 、 locomotion and slight disturbance of cognition.In control group,10 cases were followed to 6 month aged.Eight cases occurred ventriculus enlarging,covering 80%.Three cases appeared obvious locomotion and intelligence hypoevolutism;2 cases occurred slight disturbance of cognition and behavior. ConclusionGM 1 can decrease the occurrence of periventricular leukomalalia and continued white matter damage.