神经节苷脂对早产儿脑白质损伤的临床疗效观察与分析

Observe and analyse the clinical curative effect of using GM-1 on treating premature white matter damage.

目的探讨神经节苷脂(GM1)在早产儿脑白质损伤治疗中的临床意义。方法对入住北京大学第一医院新生儿ICU病房的早产儿于生后1周内常规行床旁头颅B超检查,将确诊为脑白质损伤(WMD)的89例患儿分为GM1治疗组及对照组。在积极治疗早产儿各项并发症的基础上,治疗组另给予GM1治疗,动态观察头颅B超的变化情况并进行随访。结果在收治的356例早产儿中,确诊WMD的患儿89例,发生率为25%。第一疗程GM-1治疗后,经头颅B超的动态观察,治疗组的56例均较对照组好转,差异有显著性(P<0·05)。治疗组中有33例患儿追踪至生后6个月,头颅超声显示16例出现了脑室扩大,占48%;2例出现了明显的智力及运动发育落后,约占6%;5例表现为限局性的肌张力、运动异常及轻微的认知障碍,占15%。对照组中有10例患儿追踪至生后6个月,8例出现脑室扩大,占80%;3例出现了明显的智力及运动发育落后,占30%;2例出现了轻微的认知及行为障碍,占20%。结论GM-1可减少脑白质软化及持续性病变的发生,改善预后。

Objective To study on the clinical significance of GM-1 in treating the premature white matter damage. Methods All premature infants who were hospitalized in NICU received routine bedside cranial sonography detection before 1 week-aged. Divide the confirmed patients into GM-1 treating group and control group. The treating group consisted of 56 cases ;control group of 33 cases. On the basis of being positive treated complicating disease,the treating group also accepted the treatment of GM-1. Dynamically observe the changing of cranial sonography and follow up. Results Of 356 cases,89 were confirmed, and the proportion was 25%, After one course of treatment observe the recovery of cranial sonography. The treating group was better than the control group. The divergence had prominence. Thirty-three cases of treating group were followed up to 6 month-aged. Sixteen cases had ventriculus enlarging,covering 48% ;2 cases of obvious locomotion and intelligence hypoevolutism ;5 cases of localized abnormality of muscular tension , locomotion and slight disturbance of cognition. In control group, 10 cases were followed to 6 month-aged. Eight cases occurred ventriculus enlarging,coveting 80%. Three cases appeared obvious locomotion and intelligence hypoevolutism;2 cases occurred slight disturbance of cognition and behavior. Conclusion GM-1 can decrease the occurrence of periventricular leukomalalia and continued white matter damage.