亚低温与促红细胞生成素联合治疗新生儿缺氧缺血性脑损伤的效果

目的 探讨亚低温联合促红细胞生成素(EPO)对缺氧缺血性脑损伤(HIBD)新生儿的疗效.方法 窒息新生儿65例随机分为联合组(16例)、低温组(24例)及常规组(25例).3组均常规治疗,低温组实施72 h的全身亚低温治疗,联合组在亚低温治疗的同时加用EPO300 IU/(kg·次),隔日1次,连用6次].并对各组早期(治疗0、12、24、48、72与80 h)的新生儿神经学评分,生后7、14、28 d 的新生儿行为神经测定(NBNA),生后3、6个月智能发育评估(CDCC)及6个月的随访情况进行分析.并对检测结果进行方差分析.结果 联合组治疗24、48、72 与80 h的神经学评分较常规组及治疗前、治疗12 h均显著降低(Pa﹤0.05);生后14、28 d时联合组、低温组NBNA评分均明显高于常规组(Pa﹤0.05);联合与低温组3个月与6个月智力发育指数(MDI)、心理运动发育指数(PDI)均明显高于常规组(Pa﹤0.05);但联合与低温组之间各指标均无显著性差异(Pa >0.05). 结论全身亚低温与EPO的联合应用对HIBD可发挥明显的短期和较长期的保护作用,但与单纯亚低温相比无明显的协同效应.

Effect of Subhypothermia and Erythropoietin Combined Treatment on Neonatal Hypoxic-Ischemic Brain Damage

Objective To explore the effect of systemic subhypothermia and erythropoietin combined treatment on neonatal hypoxic-ischemic brain damage(HIBD).Methods Sixty-five asphyxiated newborns enrolled in this study were divided randomly into combination group(n=16),hypothermia group(n=24)and conventional group(n=25).Subhypothermia was adepted in hypotheria group as well as conventional therapy.Subhypotheria and erythropoietin were both applied in combination group excepy for conventional therapy.The short-term effect was evaluated by neonatal neurological score as well as neonatal behavioral neurological assessment(NBNA)on postnatal days of 7,14 and 28,and the long-term effect was evaluated by using intellectual development table made by Children's Development Center of China(CDCC)at 3 and 6 month of age.Results The neonatal neurological score in combination group at 24,48,72 and 80 h were lower than that of 0 and 12 h.NBNA evaluation was much higher on 14 d and 28 d in combination group and hypothermia group than that in conventional group(Pa<0.05).The scores of mental developmental index(MDI)at 3 months of age as well as MDI and psycho-moter developmental index(PDI)at 6 months of age in combination group and hypothermia group were all much higher than those of conventional group(Pa<0.05).But no significant difference exist between combination group and hypothermia group(Pa>0.05).Conclusions Combination therapy with systemic subhypothermia and erythropoietin exerts obvious short and longer-time neuroprotective effect on HIBD,but there are no differences compared with hypothermia alone.