亚低温联合神经营养因子治疗新生儿缺氧缺血性脑病的效果及预后分析

目的:分析亚低温(Mild hypothermia,MH)联合神经营养因子治疗新生儿缺氧缺血性脑病(Neonatal hypoxic-ischemic encephalopathy,HIE)的效果及预后。方法:将2017年12月至2019年3月在我院出生的64例HIE患儿按随机数字表法分为观察组与对照组,每组各32例。其中对照组患儿接受亚低温治疗,观察组患儿联合神经营养因子治疗,对比两组患儿临床症状恢复时间,之前前后血清生化指标、氧化应激水平情况。两组患儿治疗28天后,分别采用新生儿神经行为测定(Neonatal behavioral assessment scale,NBNA)评分、婴幼儿发育贝利量表(Bayley scales of infant development,BSID)对新生儿及18月龄的患儿发育情况进行评定。结果:观察组患儿意识、反射及肌张力恢复时间明显短于对照组(P<0.05);治疗后两组患儿神经营养因子(Neurotrophin,NTF)、神经生长因子(Nerve growth factor,NGF)、超氧化物歧化酶(Oxide dismutase,SOD)水平上升,血清髓鞘碱性蛋白(Serum myelin basic protein,MBP)、神经元特异性烯醇化酶(Neuron specific enolase,NSE)及丙二醛(Malondialdehyde,MDA)水平下降,但观察组更显著;且治疗28d后观察组患儿新生儿神经行为测定(Neonatal behavioral assessment scale,NBNA)评分、18月龄时婴幼儿发育贝利量表(Bayley scales of infant development,BSID)各项目评分均显著优于对照组(P<0.05)。结论:亚低温联合神经营养因子治疗新生儿缺氧缺血性脑病疗效显著,于预后有益。

Effect and prognosis of mild hypothermia combined with neμrotrophic factors in the treatment of neonatal hypoxic-ischemic encephalopathy

Objective:To analyze the effect of mild hypothermia(MH)combined with neurotrophic factors in the treatment of neonatal hypoxic-ischemic encephalopathy(HIE)and its prognosis.Methods:A total of 64 neonates with HIE who were born in the hospital between December 2017and March 2019 were divided into the observation group and the control group by random number table method,with 32 cases in each group.The control group was treated with MH,and the observation group was treated with MH combined with neurotrophic factors.The recovery time of clinical symptoms,serum biochemical indicators and oxidative stress levels between the two groups were compared.After treatment for 28 days,the Neonatal Behavioral Assessment Scale(NBNA)score and the Bayley Scales of Infant development(BSID)were used to evaluate the development of newborns and 18-month-old children.Results:The recovery time of consciousness,reflex and muscle tension in the observation group was shorter than that in the control group(P<0.05).After treatment,the levels of neurotrophic factor(NTF),nerve growth factor(NGF),and superoxide dismutase(SOD)in the two groups increased,and serum myelin basic protein(MBP),neuron specific enolase(NSE)and malondialdehyde(MDA)levels decreased,but the observation group was more significant.After treatment for 28 days,the observation group’s Neonatal Behavioral Assessment Scale(NBNA)scores and the Bayley Scales of Infant development(BSID)scores at the age of 18 months were significantly better than those of the control group(P<0.05).After treatment,levels of NTF,NGF and SOD in both groups increased,while levels of MBP,NSE and MDA decreased.Changes of the indexes were more significant in the observation group.The NBNA score of observation group after 28 d of treatment and Bayley score at 18 months old were significantly better than those of the control group(P<0.05).Conclusion:MH combined with neurotrophic factors is effective in the treatment of neonatal HIE,which is beneficial to the prognosis.