不同时间应用GM1治疗新生儿缺氧缺血性脑病的疗效分析

Therapeutic Effects of Monosialotetrahexosyl Ganglioside on Newborn Infants with Hypoxic-Ischemic Encephalopathy in Different Times

目的比较不同时间应用单唾液酸四己糖神经节苷脂（GM1）治疗新生儿缺氧缺血性脑病（HIE）的疗效。方法89例新生儿HIE分为GM1治疗组及对照组。治疗组根据生后开始应用GM1的时间分为GM1 A、GM1 B及GM1 C共3组,其开始应用GM1的时间分别为生后6h、6-24h及24-72h。比较各组神经系统症状恢复时间、治疗前后行为神经评分（NBNA）及头颅CT恢复正常比率。结果与对照组比较,GM1 A及GM1 B组在临床症状恢复时间、治疗结束后的NBNA评分及头颅CT恢复正常比率方面均明显优于对照组（P〈0.05）,且以GM1 A组效果最明显;随开始治疗时间的延迟,GM1疗效明显下降。结论GM1治疗新生儿HIE有效,其时间窗可能在缺氧缺血后6h,但可持续到损伤后24h,以后疗效明显降低。

Objective To observe the therapeutic effects of monosialotetrahexosyl ganglioside on newborn infants with hypoxic-ischemic encephalopathy in different times.Methods Eighty-nine neonates with hypoxic-ischemic encephalopathy were divided into control group and three GM1 treatment groups,including GM1 A group（giving GM1 within 6 hours after birth）,GM1 B group（giving GM1 between 6 to 24 hours after birth） and GM1 C group（giving GM1 between 24 to 72 hours after birth）.The recover time of neurological symptoms and signs,score of neonatal behavioral neurological assessment（NBNA） and brain CT were evaluated in each group.Results The recover time of neurological symptoms and signs,the score of NBNA and the brain CT in GM1 A and GM1 B groups were better than those in control group（P0.05）,especially in GM1 A group.With the delay of administing GM1 time,the therapeutic effect of GM1 was decreased obviously.Conclusions GM1 is a promising treatment for hypoxic-ischemic encephalopathy with in 6~24 hours therapeutic window after the onset of ischemia.