川芎嗪治疗新生儿缺血缺氧性脑病疗效观察以及机制研究

Effect and mechanism of tetramethylpyrazine on newborn hypoxic-ischemic encephalopathy

目的川芎嗪治疗新生儿缺血缺氧性脑病(HIE)的疗效观察以及机制研究。方法40名HIE患儿随机分为治疗组(n=20)和对照组(n=20),两组均给以一般治疗的同时治疗组以于川芎嗪治疗。两组治疗前后分别测定血浆神经元特异性烯醇化酶(NSE)、红细胞总钙量(EryCaT)、脑型肌酸激酶(CK-BB)、丙二醛(MDA)、一氧化氮(NO)和超氧化物歧化酶(SOD),并观察临床疗效。同时与20例正常新生儿作健康对照组。结果治疗组治疗后NSE、EryCaT、CK-BB、MDA和NO水平均较治疗前明显下降,而SOD则明显升高(均P<0.01)。对照组治疗后,除EryCaT明显降低外,其余指标无明显变化。治疗后,治疗组NSE、EryCaT、CK-BB、MDA和NO水平均较对照组明显降低(P<0.01或P<0.05),而SOD则较对照组明显升高(P<0.01)。治疗组HIE治疗总有效率明显高于对照组(P<0.01)。结论川芎嗪对HIE新生儿脑组织有保护作用,机制可能和抑制钙超载和清除自由基有关。

[Objective] To study the effect and mechanism of tetramethylpyrazine on newborn hypoxic-ischemic encephalopathy. [Methods] Forty newborns with hypoxic-ischemic encephalopathy were randomly divided into two groups： management group （n=20） with conventional therapy for HIE and tetramethylpyrazine, control group only with conventional therapy for HIE. Neurone specific enolase（NSE）, erythrocytic calcium test（EryCaT）, BB isoenzyme of creatine kinase（CK-BB）, Malondialdehyde（MDA）, superoxide dismutase （SOD） and nitrogen monoxidum（NO） were measured in two groups before and after treatment and the clinical symptoms and physical signs were monitored simuhaneously. [Results] The levels of NSE, EryCaT, CK-BB, MDA and NO after treatment in management group were lower than those before treatment significantly but SOD was high significantly （P 〈0.01）. While, the levels of NSE, SOD, CK-BB, MDA and NO after treatment in control group had no significant difference with those before treatment. But EryCaT was significantly lower （P 〈0.01）. After treatment, the levels of NSE, EryCaT, CK-BB, MDA and NO in the management group were significantly lower than those in the control group while SOD was significantly higher （P 〈0.01）. The therapy effective power of management group was higher than that in the control group significantly（P 〈0.01）. [Conclusion] Totramethylpyrazine has protective effect on newborn hypoxic-ischemic encephalopathy while the mechanism is about the inhibition on calcium overload and the elimination of free radicals.