促红细胞生成素联合头部亚低温治疗新生儿脑损伤的评价

目的:探讨促红细胞生成素(EPO)联合头部亚低温治疗新生儿脑损伤(NBD)的疗效。方法:脑损伤新生儿86例随机分为治疗组46例和对照组40例。治疗组应用重组人促红细胞生成素(rhEPO)100 U/kg肌肉或静脉注射,每周3次,应用2周;治疗组同时采用FX-2000亚低温治疗仪(深圳)头部亚低温治疗持续72 h,亚低温治疗结束后自然复温。对照组按HIE治疗方案进行。对各组于生后7 d、14 d、21 d、28 d进行新生儿行为神经测定(NBNA),并对生后3个月、6个月智能发育评估(CDCC)及6个月的随访情况进行分析。结果:生后7 d、14 d、21 d、28 d时治疗组NBNA评分高于对照组(t分别为2.008、5.341、6.238、7.485,P均<0.05);治疗组3个月与6个月智力发育指数(MDI)、心理运动发育指数(PDI)均高于对照组(P<0.05)。结论:头部亚低温与EPO的联合治疗新生儿脑损伤短期和远期效果优于常规治疗。

Evaluation of Combined Treatment with Erythropoietin and Cephalosome Subhypothermia on Neonatal Brain Damage

Objective:To evaluate the effect of combined treatment with erythropoietin and cephalosome subhypothermia on neonatal brain damage(NBD).Methods: Eighty-six brain damaged newborns enrolled in this study were divided randomly into combination group(n=46) and conventional group(n=40).The effect was evaluated by neonatal behavioral neurological assessment(NBNA)(on days 7,14,21 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 months of age.Results: On days 7,14,21 and 28,NBNA evaluation was much higher in combination group than that in conventional group(t=2.008,t=5.341,t=6.238,t=7.485,P<0.05).The scores of mental developmental index(MDI) at 3 months of age as well as MDI and psycho-motor developmental index(PDI) at 6 months of age in combination group were much higher than those of the conventional group(P<0.05).Conclusions: Combination therapy with systemic subhypothermia and erythropoietin exerts obvious short-time and long-time neuroprotective effect on NBD,but there are no differences compared with hypothermia treatment.