单唾液酸四已糖神经节苷酯联合胞二磷胆碱治疗中、重度新生儿缺氧缺血性脑病的疗效分析

Effects of Monosialotetrahexosylganglioside Combined with Citicoline in Treatment of Maderate and Severe Neonatal Hypoxic-Ischemic Emcephalopathy

目的:探讨单唾液酸四已糖神经节苷酯联合胞二磷胆碱治疗中、重度新生儿缺氧缺血性脑病(HIE)的临床疗效。方法:将本院儿科2010年1月-2013年1月住院的中、重度HIE患儿98例按随机数字表法分为治疗组和对照组,均采用三维持、三对症的综合治疗方案。对照组49例加用胞二磷胆碱(CDPC)治疗,治疗组49例在对照组的基础上加用单唾液酸四已糖神经节苷酯(GM-1)进行治疗,观察两组患儿的症状体征,行脑CT判定和NBNA评分评估疗效。结果:治疗组临床疗效总有效率为93.88%,显著高于对照组(P<0.05);脑CT变化比较:治疗组明显优于对照组(P<0.05);NABA评分:治疗组与对照组在生后2 d内评分差异无统计学意义(P>0.05),生后7、14、28 d评分治疗组明显高于对照组,差异均具有统计学意义(P<0.05)。结论:GM-1与CDPC合用可发挥协同作用,促进受损神经细胞功能修复,逆转脑缺氧缺血后神经功能障碍,显著提高脑机能,可明显改善中重度HIE的临床症状,适于临床推广。

Objective： To investigate the clinical effieacy of the Monosialotetrahexosylganglioside （ GM-1 ） combined with citicoline in the treatment of severe neonatal hypoxic-ischemic encephalopathy （ HIE ） . Method： From January 2010 to January 2010 , the data of 98 children with severe HIE were retrospectively analyzed in department of pediatric in our hospital. All the cases were treated by three in the support and the basis of the three symptomatic .The control group （ n=49 ） was treated with citicoline （ CDPC ） together with conventional trerapy for HIE. The treatment group （ n=49 ） was treated with GM-I on the basis of the control group. The symptoms and signs of the two groups were observed.Brain CT and the neonatal behavioral neurological assessment （ NBNA ） scores of the two groups were evaluated. Result： The total effective rate in the observation group was 93.86%, significantly higher than that in the control group. Brain CT changes in treatment group was better than that in the control group.The NBNA scores （ 2 d ） in the treatment group was no significant difference, the NBNA scores （ 7, 14, 28 d ） were significantly higher than those in the control group （P〈0.05） .Conclusion： GM-1 combined with Citicoline could significantly promote the injury central nerous system functional recovery and improve brain dysfunction in treatment of maderate and severe neonatal HIE. Thus it＇s worthy of clinical application.