尼莫地平对新生儿HIE治疗作用的研究

Study on the Effect of Nimodipine on Neonatal Hypoxicischemic Encephalopalopathy

目的 为探讨尼莫地平对新生儿缺氧缺血性脑病(HIE)的治疗作用.方法 将HIE新生儿43例,分为尼莫地平治疗组21例和对照组22例.治疗组于生后12小时内开始使用尼莫地平口服治疗5mg/(kg.d),每日分2次,疗程5天.其余治疗和处理两组相同,于生后12小时、24小时、72小时检测RBCTCa和Ca^(2+)i的含量,并于后后3日,7日行新生儿行为神经测定(20项NBNA评分).结果 显示对照组12h,24h,RBCTCa和Ca^(2+)i均高于治疗各时相组,差异有显著性意义(P<0.01).两组患儿生后3日20项NBNA评分均明显低于正常,两组间无统计学差异.生后7日20项NBNA评分治疗组明显高于对照组(P<0.001).结论 早期使用尼莫地平能阻止Ca^(2+)内流,从而达到保护神经元。

ve To investigate the effect of nimodipine on neonatal hypoxic-ischemic en-cephalopathy. Methods It involved 43 newborn infants with hypoxic-ischemic encephalopathy (HIE). These infants were divided into two groups: the HIE nimodipine treatment group (n =21), and HIE control group (n =22). Nimodipine was used in a dose of 5mg/(kg.d)in 21 patients for 5 days. Treatment initiated within 12 hours of HIE following perinatal asphyxia. The RBC total calcium content (RBCTCa) and free calcium ion(Ca2+ i) were measured in both two groups at 12 hours, 24 hours and 72 hours postnatally, respectively. At same time, neonatal behavioral and neurological assessment (20-itme NBNA) was employed to assess the behavioral and neurological change at 3 days and 7 days of life. Results The RBCTCa and RBCCa2 +i concentration was significantly higher in HIE control group of 12 hours and 24 hours of life than that in nimodipine treatment group( P < 0.001) . No difference in 20-item NBNA was found in two groups at 3 days, but the scores of 20-item NBNA at 7 days had an obvious increase in both groups and the scores in nimodipine treatment group were higher than those in control group, showing a statistical difference (P<0. 001). Conclusion Nimodipine may block calcium fluxing into cells and protect effectively neurons from attack of calcium unnormal rising.