神经生长因子与血管内皮生长因子在新生儿缺氧缺血性脑病中的关系

Relation of nerve growth factor with vascular endothelial growth factor in hypoxic ischemic encephalopathy

目的探讨神经生长因子治疗新生儿缺氧缺血性脑病的机制及有效方案。方法选择我院2004年3月～2007年3月本院新生儿病房生后3天内符合全国HIE诊断标准13J的患儿82例随机分为对照组和观察组,分别于住院当天、住院3天和住院7天分别进行血浆血管内皮生长因子、CT检查及B超检查;以及进行NBNA20项行为测定和神经精神发育随访。结果观察组与对照组治疗后显示肌张力、吸吮反射、拥抱反射和意识恢复时间比较有显著差异。观察组与对照组患儿颅脑B超住院3天比较脑水肿指标有极显著差异。观察组、对照组患儿血浆血管内皮生长因子与同组0天比较有显著差异。观察组与对照组小儿颅脑CT异常率住院3天、住院7天比较有显著差异。观察组与对照组小儿住院7天、住院28天NANB评分结果比较有统计学意义。6个月时随访,观察组与对照组小儿精神运动发育商有显著差异。结论外源性神经生长因子可以使受损的神经元得以修复,而在新生儿缺血缺氧性脑病的早期由于血管内皮生长因子的水平较高,不宜使用。

Objective：To explore the mechanism and the effective scheme of therapy with nerve growth factor in hypoxic ischemic encephalopathy. Methods：82 eases of children with hypoxic ischemic encephalopathy in our hospital were divided into the experiment and the control at random, and were checked respectively up serum vascular endothelial growth factor, CT, Bultrasonic in time, after 3rd and 7th day. 20 items behavior of NBNA in the children were set out. Their nervous and psychic growths were made inquiries. Results ： Recovered time of intramuscular strain,suck reflect, embrace reflect and consciousness showed a remarkable difference when experiment group compared with control group. Cranial B ultrasound showed hydrocephalic indexes remarkably different when experiment group compared with control group in hospital the 3rd day. Serum vascular endothelial growth factor had a remarkable difference when experi- ment group or control group compared with its hospital the zero clay oneself. Abnormal rate of Cranial CT had a remarkable difference when experiment group ofhospital the 3rd and 7th day compared with control group of hospital the 3rd and 7th day. NANB of assessment had a statistical significance when experiment group of hospital the 7th and 28th day compared with control group of hospital the 7th and 28th day. Their nervous and psychic growths showed a remarkable difference when experiment group compared with control group after the 6th month. Conclusion： External nerve growth factor can cover the injured nerve cells, but it may not be used because vascular en- dothelial growth factor WaS high in hypoxic ischemic encephalopathy early.