神经生长因子治疗高原地区新生儿缺氧缺血性脑病的疗效观察

摘要

Objective To investigate the clinical effects of nerve growth factor ( NGF ) on hypoxic - ischemic enceph-alopathy ( HIE ) in plateau area. Methods 252 infants with moderate to severe HIE were enrolled in the study and randomly divided into control ( 120 cases ) and treatment ( 132 cases ) groups. Besides the support therapy and symptomatic treatment for all the patients, the control group was administered cytidini diphosphatis cholinum and brain active element, while the treatment group was treated by NGF, both with a 10 ~ 15 d treatment course. In addition, those patients underwent cranial CT scans, neonatal behavioral neurological assessment ( NBNA ) and serum myelin basic protein ( MBP ) pre and post treatment respectively. Results There was significant difference in abnormal cranial CT scan rate of those moderate and severe HIE patients between two groups pre and post treatment ( P < 0. 05 ). No significant difference was found in NBNA scores between two groups pre - therapy ( P > 0. 05 ), while after one course of treatment, NBNA scores in the treatment group was markedly higher than that in the control group with significant difference ( P <0. 05 ). Serum MBP level being compared pre treatment, there was no significant difference between two groups ( P >0. 05 ). After treatment, there was no significant difference in serum MBP level between the moderate HIE patients in the two groups ( P > 0. 05 ), but the serum MBP level in the severe HIE patients in treatment group was markedly higher than that in control group with significant difference ( P < 0. 05 ). Conclusion Nerve growth factor ( NGF ) associated with routine therapy will achieve better clinic effect in plateau area where HIE incidence rate is high.%目的 探讨神经生长因子(NGF)治疗高原地区新生儿缺氧缺血性脑病(HIE)的临床疗效.方法 将252例中-重度HIE患儿随机分为对照组(120例)和治疗组(132例);均给予支持治疗和对症治疗,对照组应用胞磷胆碱及脑活素,观察组应用NGF治疗,两组疗程均为10～15 d.治疗前后分别进行颅脑CT检查、新生儿行为神经评分(NBNA)及血清髓鞘碱性蛋白(MBP)水平测定.结果 两组中度和重度HIE患儿治疗后颅脑CT异常率比较,差异均有统计学意义(P＜0.05).两组中度和重度HIE患儿治疗前NBNA评分比较,差异均无统计学意义(P＞0.05).治疗组中度和重度HIE患儿治疗1个疗程后NBNA评分较对照组均明显升高,差异有统计学意义(P＜0.05).两组中度和重度HIE患儿治疗前血清MBP水平比较,差异均无统计学意义(P＞0.05).两组中度HIE患儿治疗后血清MBP水平比较,差异无统计学意义(P＞0.05);治疗组重度HIE患儿较对照组明显升高,差异有统计学意义(P＜0.05).结论 在HIE发病率较高的高原地区,常规治疗的基础上加用NGF,可以取得更好的临床效果.