神经节苷脂治疗新生儿缺氧缺血性脑病的临床效果及其对肿瘤坏死因子α和白细胞介素6的影响

Clinical effects of neonatal hypoxic-ischemic encephalopathy treated with ganglioside and effects of tumor necrosis factor-α and interleukin-6

目的 探讨神经节苷脂在新生儿缺氧缺血性脑病（HIE）中的临床应用价值.方法 选取新生儿HIE患儿88例,将其按随机数字表法分为观察组和对照组,每组44例,两组患儿均给予一般综合治疗措施,观察组在此基础上加用神经节苷脂的临床药物治疗,对照组则在此基础上加用胞磷胆碱的临床药物治疗,并分别对两组患儿的临床治疗情况、临床症状改善情况、新生儿行为神经测定（NBNA）评分情况、肿瘤坏死因子α（TNF-α）和白细胞介素6（IL-6）水平变化情况进行比较和分析.结果 观察组总有效率为90.91％（40/44）,明显高于对照组的68.18％（30/44）,差异有统计学意义（P＜ 0.01）.观察组治疗后反射恢复时间、肌张力恢复时间、意识恢复时间分别为（7.04±1.28）、（8.13±1.42）、（5.08±0.90）d,均明显短于对照组的（10.16±1.57）、（10.98±1.33）、（9.76±1.18）d,差异有统计学意义（P＜0.05）.观察组治疗后NBNA评分较治疗前提升（10.91±1.83）分,与对照组的（9.07±1.69）分比较差异有统计学意义（P＜0.05）.观察组治疗后TNF-α、IL-6水平较治疗前分别降低（65.78±12.25）、（88.58±18.01）ng/L,与对照组的（30.10± 11.93）、（32.69±17.94） ng/L比较差异有统计学意义（P＜0.05）.结论 神经节苷脂可作为新生儿HIE的理想临床治疗药物,其作用机制可能与其降低TNF-α、IL-6水平有关.

Objective To investigate the application value of ganglioside treated for neonatal hypoxic-ischemic encephalopathy （HIE）.Methods The 88 neonatal HIE children were divided into observation group and control group according to random digits table method with 44 cases each.The children in the two groups were given general comprehensive treated measures.The children in observation group were treated with ganglioside.The children in control group were treated with citicoline.The clinical treatment situation,clinical symptoms situation,neonatal behavioral neurological assessment （NBNA） score situation,the changes of tumor necrosis factor-α （TNF-α） and interleukin-6 （IL-6） levels in the two groups were compared and analyzed.Results The total efficiency in observation group was 90.91%（40/44）,in control group was 68.18% （30/44）,there was statistically significant （P 〈 0.01）.The times of reflex recovery,muscle tension recovery and consciousness recovery in observation group were （7.04 ± 1.28）,（8.13 ± 1.42） and （5.08 ± 0.90） d,in control group were （10.16 ± 1.57）,（10.98 ± 1.33） and （9.76 ± 1.18） d,the targets in observation group were significantly shorter than those in control group （P 〈 0.05）.The change of NBNA score before and after treatment was （10.91 ± 1.83） scores in observation group,which was higher than that in control group [（9.07 ± 1.69） scores],and there was significant difference between the two groups （P〈 0.05）.The change ofTNF-α and IL-6 levels before and after treatment in observation group were （65.78 ± 12.25）and （88.58 ± 18.01） ng/L,which were lower than those in control group [（30.10 ± 11.93） and （32.69 ±17.94） ng/L],and there were significant differences between the two groups （P 〈0.05）.Conclusions Ganglioside can be used as an ideal therapeutic drug for neonatal HIE to clinical application.Its mechanism may be related to the reduction of TNF-α and IL-6 levels.