神经节苷脂对HIE患儿血浆炎症因子的影响

A clinical observation of the effect of Ganglioside on plasma level of cytokines of newborns with hypoxic ischemic encephalopathy

目的探讨神经节苷脂(GM-1)对缺血缺氧性脑病(HIE)患儿血浆炎症因子影响及疗效观察。方法选择65例HIE患儿,分成观察组和对照组。两组患儿均予以吸氧,纠正酸中毒、低血压、低血糖,抗惊厥、降低颅内压、脑细胞激活剂等对症支持治疗。观察组在此基础上加用GM-1 20 mg/次,静滴,1次/d,连用2周。观察两组患儿治疗前后血浆炎症因子白介素-6(IL-6)、白介素-8(IL-8)和肿瘤坏死因子-α(TNF-α)水平的变化,并进行临床疗效及安全性评估。结果治疗2周后,观察组的临床总有效率明显高于对照组(χ2=8.02,P<0.01);同时两组患儿治疗后血浆IL-6、IL-8和TNF-α水平均较治疗前明显下降(P<0.05或P<0.01),且观察组下降幅度较对照组更明显(P<0.05),治疗期间无明显不良反应。结论 GM-1治疗HIE患儿的疗效确切,能明显改善患儿的临床症状,安全性好,作用机制与降低血浆炎症因子水平有关。

Objective To explore and observe the effect of ganglioside （GM-1） on plasma level of cytokines of newborns with hypoxic ischemic encephalopathy （HIE）. Methods All of 65 newborns with HIE were divided into group observing and group control randomly. All the patients received support treatment as inhalating oxygen, correcting acidosis, reducing blood pressure and sugar, lowing intracranial pressure and brain cell activator. Patients in group observing received extra treatment as continuous infusion of GM-1 20 mg pertime, once a day, for 2 weeks. Observe the changes of the levels of Interleukin-6（IL-6）, Interleukin-8（IL-8） and Tumor necrosis factor-α（TNF-α）, value the clinic effect, and assess the safety of paroxetine. Results Two weeks after treatment, the clinic total effective rate of the group observing was significantly higher than that of group control （χ^2=8.02, P 〈 0.01）. The levels of IL-6,IL-8 and TNF-α of both groups decreased significantly than that before treatment （ P 〈 0.05 or P 〈 0.01）, and the changement of group observing was more obviously than that of another group （P 〈 0.05）. There was no adverse reaction during the treatment period. Conclusion There is a certain clinic effect of GM-1 on the treatment of newborns with HIE. It can improve the clinic symptom of the patients with good safety. It works though down regulating the levels of cytokines.