中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2013年
30期
4-7
,共4页
邓秀睿%林振浪%陈清%瞿尔力
鄧秀睿%林振浪%陳清%瞿爾力
산수예%림진랑%진청%구이력
缺氧缺血,脑%神经节苷脂类%肿瘤坏死因子α%白细胞介素6
缺氧缺血,腦%神經節苷脂類%腫瘤壞死因子α%白細胞介素6
결양결혈,뇌%신경절감지류%종류배사인자α%백세포개소6
Hypoxic-ischemic,brain%Gangliosides%Tumor necrosis factor-alpha%Interleukin-6
目的 探讨神经节苷脂在新生儿缺氧缺血性脑病(HIE)中的临床应用价值.方法 选取新生儿HIE患儿88例,将其按随机数字表法分为观察组和对照组,每组44例,两组患儿均给予一般综合治疗措施,观察组在此基础上加用神经节苷脂的临床药物治疗,对照组则在此基础上加用胞磷胆碱的临床药物治疗,并分别对两组患儿的临床治疗情况、临床症状改善情况、新生儿行为神经测定(NBNA)评分情况、肿瘤坏死因子α(TNF-α)和白细胞介素6(IL-6)水平变化情况进行比较和分析.结果 观察组总有效率为90.91％(40/44),明显高于对照组的68.18％(30/44),差异有统计学意义(P＜ 0.01).观察组治疗后反射恢复时间、肌张力恢复时间、意识恢复时间分别为(7.04±1.28)、(8.13±1.42)、(5.08±0.90)d,均明显短于对照组的(10.16±1.57)、(10.98±1.33)、(9.76±1.18)d,差异有统计学意义(P＜0.05).观察组治疗后NBNA评分较治疗前提升(10.91±1.83)分,与对照组的(9.07±1.69)分比较差异有统计学意义(P＜0.05).观察组治疗后TNF-α、IL-6水平较治疗前分别降低(65.78±12.25)、(88.58±18.01)ng/L,与对照组的(30.10± 11.93)、(32.69±17.94) ng/L比较差异有统计学意义(P＜0.05).结论 神经节苷脂可作为新生儿HIE的理想临床治疗药物,其作用机制可能与其降低TNF-α、IL-6水平有关.
目的 探討神經節苷脂在新生兒缺氧缺血性腦病(HIE)中的臨床應用價值.方法 選取新生兒HIE患兒88例,將其按隨機數字錶法分為觀察組和對照組,每組44例,兩組患兒均給予一般綜閤治療措施,觀察組在此基礎上加用神經節苷脂的臨床藥物治療,對照組則在此基礎上加用胞燐膽堿的臨床藥物治療,併分彆對兩組患兒的臨床治療情況、臨床癥狀改善情況、新生兒行為神經測定(NBNA)評分情況、腫瘤壞死因子α(TNF-α)和白細胞介素6(IL-6)水平變化情況進行比較和分析.結果 觀察組總有效率為90.91％(40/44),明顯高于對照組的68.18％(30/44),差異有統計學意義(P＜ 0.01).觀察組治療後反射恢複時間、肌張力恢複時間、意識恢複時間分彆為(7.04±1.28)、(8.13±1.42)、(5.08±0.90)d,均明顯短于對照組的(10.16±1.57)、(10.98±1.33)、(9.76±1.18)d,差異有統計學意義(P＜0.05).觀察組治療後NBNA評分較治療前提升(10.91±1.83)分,與對照組的(9.07±1.69)分比較差異有統計學意義(P＜0.05).觀察組治療後TNF-α、IL-6水平較治療前分彆降低(65.78±12.25)、(88.58±18.01)ng/L,與對照組的(30.10± 11.93)、(32.69±17.94) ng/L比較差異有統計學意義(P＜0.05).結論 神經節苷脂可作為新生兒HIE的理想臨床治療藥物,其作用機製可能與其降低TNF-α、IL-6水平有關.
목적 탐토신경절감지재신생인결양결혈성뇌병(HIE)중적림상응용개치.방법 선취신생인HIE환인88례,장기안수궤수자표법분위관찰조화대조조,매조44례,량조환인균급여일반종합치료조시,관찰조재차기출상가용신경절감지적림상약물치료,대조조칙재차기출상가용포린담감적림상약물치료,병분별대량조환인적림상치료정황、림상증상개선정황、신생인행위신경측정(NBNA)평분정황、종류배사인자α(TNF-α)화백세포개소6(IL-6)수평변화정황진행비교화분석.결과 관찰조총유효솔위90.91％(40/44),명현고우대조조적68.18％(30/44),차이유통계학의의(P＜ 0.01).관찰조치료후반사회복시간、기장력회복시간、의식회복시간분별위(7.04±1.28)、(8.13±1.42)、(5.08±0.90)d,균명현단우대조조적(10.16±1.57)、(10.98±1.33)、(9.76±1.18)d,차이유통계학의의(P＜0.05).관찰조치료후NBNA평분교치료전제승(10.91±1.83)분,여대조조적(9.07±1.69)분비교차이유통계학의의(P＜0.05).관찰조치료후TNF-α、IL-6수평교치료전분별강저(65.78±12.25)、(88.58±18.01)ng/L,여대조조적(30.10± 11.93)、(32.69±17.94) ng/L비교차이유통계학의의(P＜0.05).결론 신경절감지가작위신생인HIE적이상림상치료약물,기작용궤제가능여기강저TNF-α、IL-6수평유관.
Objective To investigate the application value of ganglioside treated for neonatal hypoxic-ischemic encephalopathy (HIE).Methods The 88 neonatal HIE children were divided into observation group and control group according to random digits table method with 44 cases each.The children in the two groups were given general comprehensive treated measures.The children in observation group were treated with ganglioside.The children in control group were treated with citicoline.The clinical treatment situation,clinical symptoms situation,neonatal behavioral neurological assessment (NBNA) score situation,the changes of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) levels in the two groups were compared and analyzed.Results The total efficiency in observation group was 90.91％(40/44),in control group was 68.18％ (30/44),there was statistically significant (P ＜ 0.01).The times of reflex recovery,muscle tension recovery and consciousness recovery in observation group were (7.04 ± 1.28),(8.13 ± 1.42) and (5.08 ± 0.90) d,in control group were (10.16 ± 1.57),(10.98 ± 1.33) and (9.76 ± 1.18) d,the targets in observation group were significantly shorter than those in control group (P ＜ 0.05).The change of NBNA score before and after treatment was (10.91 ± 1.83) scores in observation group,which was higher than that in control group [(9.07 ± 1.69) scores],and there was significant difference between the two groups (P＜ 0.05).The change ofTNF-α and IL-6 levels before and after treatment in observation group were (65.78 ± 12.25)and (88.58 ± 18.01) ng/L,which were lower than those in control group [(30.10 ± 11.93) and (32.69 ±17.94) ng/L],and there were significant differences between the two groups (P ＜0.05).Conclusions Ganglioside can be used as an ideal therapeutic drug for neonatal HIE to clinical application.Its mechanism may be related to the reduction of TNF-α and IL-6 levels.
