生脉注射液对缺氧缺血性脑病新生儿脑血流动力学影响

Changes of Cerebral Haemodynamics in Neonates with Hypoxic-Ischemic Encephalopathy Treated with Shengmai Injection

目的利用彩色多普勒超声研究缺氧缺血性脑病(HIE)新生儿脑血流动力学变化,观察生脉注射液对HIE新生儿脑血流动力学的影响,探索HIE早期治疗干预措施。方法将50例HIE患儿随机分为生脉组(30例)和胞磷胆碱组(20例),分别于治疗前及治疗1周后进行脑血流动力学参数。包括大脑中动脉和大脑前动脉的收缩期峰值流速(PSFV)、舒张末期血流速度(EDFV)、搏动指数(PI)、阻力指数(RI)检测,并与正常对照组进行对比研究。结果HIE患儿PSFV、PI及RI均低于正常对照组,差异均有显著性(P均<0.05);两组治疗后PSFV、EDFV、RI较治疗前明显提高(P<0.01,0.05),生脉组大脑前动脉血流速度的改善明显高于胞磷胆碱组(P<0.01,0.05)。结论HIE新生儿脑血流动力学出现明显紊乱,应用无损伤性彩色超声诊断仪监测脑血流动力学变化有助于早期评估其预后,并指导临床治疗;生脉注射液、胞磷胆碱治疗HIE均有效,但生脉注射液优于胞磷胆碱。

Objective To study the changes of cerebral haemodynarnies in neonates with bypoxic - ischemic encephalopathy （HIE） treated with Shengmai injection compared with citicoline, and explore the clinical interventions of Shengmai injection on HIE. Methods Fifty patients with HIE were randomized into 2 groups： Shengrnai group treated with Shengrnai injection （ n = 30）, and citicoline group treated with citicoline （ n = 20）. The haemodynamic parameters included peak systolic flow velocity （PSFV）, end - diastolic flow velocity （EDFV）, pulsation index （PI） and resistance index （RI） of anterior and middle cerebral artery were detected by color Doppler ultrasound before treatment and on 7th day after treatment respectively. Control group （ n = 50） compared with the two groups. Results PSFV, PDFV and RI of HIE patients were significantly lower than those of control group （P〈 0.05 ）, and they increased apparently after therapy （P 〈 0.01,0.05 ）. The blood flow velocity of anterior cerebral artery in Shengmai group got more improvement than that in citicoline group. There was a significant difference between two groups （P〈 0.01,0.05）. Conclusions The cerebral haemodynamics in neonates with HIE is in disorder apparently. It will help to evaluate the prognosis of HIE and guide the clinical therapy of HIE using color Doppler ultrasound to monitor the haemodynamics. The therapy effects of Shengmai injection and citicoline on neonatal HIE are obvious, and the prior is better than the later.