鼠神经生长因子对新生儿缺氧缺血性脑病患儿血清神经肽 Y和神经元特异性烯醇化酶水平的影响及疗效观察

摘要

目的：：探讨鼠神经生长因子对新生儿缺氧缺血性脑病(HIE)患儿血清神经肽Y(NPY)和神经元特异性烯醇化酶( NSE)水平的影响及疗效观察。方法：采用随机数字表法将70例新生儿HIE患儿分成观察组和对照组。两组患儿均予以吸氧、控制颅内压、血压和血糖,抗惊厥、保持水电解质平衡等常规治疗。观察组患儿加用鼠神经生长因子20μg, im,qd。对照组患儿加用胞磷胆碱注射液100 mg,ivd,qd,均连用10~14 d。观察两组患儿治疗前后血清NPY 和NSE水平变化,比较两组疗效及药品不良反应,随访1年内神经系统后遗症的发生率。结果：治疗2周后,两组血清NPY和NSE水平较前均明显下降(P<0.05和P<0.01),且观察组下降幅度明显大于对照组(P<0.05)；观察组临床总有效率为94.28%,明显高于对照组的68.57%(P<0.01),两组患儿治疗中未出现明显药品不良反应。随访观察1年,观察组后遗症的发生率明显低于对照组(P<0.05)。结论：鼠神经生长因子治疗新生儿HIE的疗效肯定,安全性好,可促进受损神经元细胞的修复,减少神经系统后遗症的发生率,其作用与降低血清NPY和NSE水平密切相关。%To discuss the therapeutic effect and influence of rat NGF on serum neuropeptide Y ( NPY) and neuron-specificenolase (NSE) levels in newborn with neonatal hypoxic and ischemic encephalopathy (HIE). Methods: Totally 70 cases of neonatal HIE patients were selected and divided into the observation group and the control group at random. The children in the two groups were given the routine medical treatment such as oxygen uptake, the control of intracranial pressure, blood pressure and blood sugar, anticonvulsant, balance of water and electrolyte and etc. The children in the observation group were additionally given 20μg rat NGF through intramuscular injection once a day. The children in the control group were additionally given 100 mg citicoline through in-travenous drip once a day. The treatment course was 10-14 days. The changes of serum NPY and NSE levels, clinical curative effect and adverse drug reactions ( ADR) in the two groups were compared, and the occurrence of nervous system sequel after the medical treatment was compared and followed up. Results: After the 2-week medical treatment, the serum NPY and NSE levels in the two groups were declined (P<0. 05 or P<0. 01), and the declining in the observation group was more notable than that in the control group (P<0. 05). The total clinical efficiency in the observation group was 94. 28%, which was much higher than that (68. 57%) in the control group (P<0. 01). No obvious adverse drug reaction appeared in the two groups during the treatment. After the one-year follow up, the occurrence of sequel was 5. 71% in the observation group, which was much lower than that (22. 86%) in the control group(P<0. 05). Conclusion:Rat NGF has reliable curative effect on neonatal HIE with high security, which can improve the repair of impaired neuronal cells, reduce the occurrence of sequel of neuronal cells and enhance the prognosis, and the mechanism may relat-ed with the reduction of serum NPY and NSE levels.