神经节苷脂GM1治疗新生儿缺氧缺血性脑病的血浆神经元特异性烯醇酶动态变化

目的研究神经节苷脂GM1治疗新生儿缺氧缺血性脑病患儿血浆神经元特异性烯醇酶（NSE）的动态变化及其临床意义。方法将新生儿科住院的90例新生儿缺氧缺血性脑病患儿分为轻度组18例、常规治疗组33例、GM1组39例。GM1组在常规治疗基础上加用神经节苷脂，20mg／次，静脉滴注1次／d，10～14d为1个疗程。治疗前后分别检测血浆NSE，同时以25例正常新生儿组作对照。治疗前及治疗1个疗程后各进行脑CT检查1次；治疗前、治疗1个疗程后和生后28d各进行NBNA测定1次；生后1个月起至生后12个月每月DQ检测1次。结果GM1组和常规治疗组治疗后血浆神经元特异性烯醇酶有显著下降（P〈0．05），GM1组比常规治疗组下降更显著。轻度组血浆神经元特异性烯醇酶改变差异无统计学意义（P〉0．05）。GM1组在CT好转率、NBNA评分及DQ评分意识障碍恢复方面明显好于常规治疗组（P〈0．05），差异有统计学意义。结论神经节苷脂治疗新生儿缺氧缺血性脑病具有十分重要价值。

Dynamic changes of plasma neuron-specific enolase level in neonates with hypoxic-ischemic encephalopathy treated by gangliosides

Objective To study the dynamic changes and clinical significance of plasma neuron - specific enolase level in neonates with hypoxic - ischemic encephalopathy treated by gangliosides. Methods 90 cases of HIE were randomly divided into routine treatment group,mild group and control group,and all groups received combined treatment. Injection of ganglioside was added in the treatment group once a day, 20mg each time, 10 - 14 days as a course of treatment. NSE, brain CT, NBNA marks and DQ in 1 - 12 months after birth were indexes for evaluation. Results The serum NSE level of routine treatment group and control group was significantly lower than that of routine control （ P 〈 0. 05 ）. Control group was significantly lower than that of routine treatment group （ P 〈 0. 05 ）. The brain CT degree, NBNA and DQ score of GM1 group was significantly higher than that of routine control （ P 〈 0. 05 ）. Conclusion The treatment of GM1 has a more important value in HIE.