选择性头部亚低温联合复方丹参注射液治疗新生儿缺氧缺血性脑病的有效性和安全性

Selective Head Cooling Combined with Compound Salvia Miltiorrhiza Injection in the Treatment of Neonatal Hypoxic Ischemic Encephalopathy

目的:探讨选择性头部亚低温(SHC)联合复方丹参注射液在新生儿缺氧缺血性脑病(HIE)的临床应用价值。方法:选取我院2015年2月至2017年2月治疗的HIE患儿74例,按随机数表法分为对照组和观察组各37例。对照组患儿采用临床常规方案治疗,包括应用SHC及常规药物支持治疗;观察组患儿在对照组基础上联合复方丹参注射液治疗,比较两组患儿治疗前、治疗7 d后的血清氧化应激标志物及炎性因子水平,记录相关临床症状体征恢复时间,综合评价疗效并记录不良反应发生情况。结果:观察组患儿的总有效率为91. 89%,高于对照组的81. 08%(P<0. 05);原始反射、意识、肌张力恢复时间均短于对照组(P均<0. 01)。两组患儿治疗后的血清IL-6、IL-8、TNF-α、丙二醛水平均降低,且观察组均低于对照组(P均<0. 01);两组患儿治疗后的血清超氧化物歧化酶、谷胱甘肽过氧化物酶水平均升高,且观察组均高于对照组(P均<0. 01)。观察组不良反应发生率为10. 81%,对照组为5. 41%,两组比较差异无统计学意义(P>0. 05)。结论:SHC联合复方丹参注射液能显著改善HIE患儿的临床症状、体征,减轻炎症反应及氧化应激反应,应用于临床安全、有效。

Objective: To investigate the clinical application value of selective head cooling(SHC) combined with compound salvia miltiorrhiza injection in the treatment of neonatal hypoxic ischemic encephalopathy( HIE). Methods: Seventy-four patients with HIE admitted into our hospital from Feb. 2015 to Feb. 2017 were selected to be divided into the control group and the observation group via the random number table,with 37 cases in each group. Children in the control group were treated with conventional clinical regimen,including SHC and conventional drug support therapy. Children in the observation group received compound salvia miltiorrhiza injection on the basis of the control group. Serum oxidative stress markers and inflammatory factors were compared between two groups before treatment and 7 d after treatment,and the recovery time of relevant clinical symptoms and signs were recorded. The efficacy was comprehensively evaluated and the incidence of adverse drug reactions was recorded. Results: The total effective rate of the observation group was 91. 89%,higher than 81. 08% of the control group( P<0. 05),the recovery time of original reflex,consciousness and muscle tension was shorter than that of the control group( P<0. 01). The serum IL-6,IL-8,TNF-α,malondialdehyde levels were decreased in both groups after treatment,and the observation group was lower than the control group( P<0. 01). The serum superoxide dismutase and glutathione peroxidase levels were increased in both groups after treatment,and the observation group was higher than the control group(P<0. 01). The incidence of adverse drug reactions was 10. 81% in the observation group and 5. 41% in the control group,and there was no statistically significant difference between two groups( P >0. 05). Conclusion: SHC combined with compound salvia miltiorrhiza injection can significantly improve the clinical symptoms and signs of children with HIE,reduce the inflammatory reactions and oxidative stress reactions,and it is safe and effective in clinical application.