脑苷肌肽对高原地区新生儿缺氧缺血性脑病脑脊液可溶性髓样细胞触发受体-1、胰岛素样生长因子-1、髓鞘碱性蛋白的影响

Effects of cattle encephalon glycoside and ignotin on the s ICAM-1,IGF-1,MBP levels in cerebrospinal fluid of patients with hypoxic ischemic encephalopathy in plateau region

目的：研究脑苷肌肽对高原地区新生儿缺氧缺血脑病患者疗效及其对脑脊液中可溶性髓样细胞触发受体-1、胰岛素样生长因子-1、髓鞘碱性蛋白水平的影响。方法：选取2011年2月~2014年6月笔者所在医院儿科收治的新生儿缺氧缺血脑病患者114例,随机均分为脑苷肌肽治疗组和常规治疗组,另选30例健康新生儿作为对照;常规治疗组给予常规基础治疗,脑苷肌肽治疗组患者在基础治疗上加用脑苷肌肽注射液,疗程为2周,每日1次,每次10ml静脉滴注。治疗后考察临床疗效和患者脑脊液中可溶性髓样细胞触发受体-1、胰岛素样生长因子-1、髓鞘碱性蛋白的水平变化。结果：与健康对照组比较,中、重度新生儿缺氧缺血脑病患儿胰岛素样生长因子-1水平显著下调（P〈0.05）,可溶性髓样细胞触发受体-1、髓鞘碱性蛋白水平显著上调（P〈0.05）;与轻度组比较,中、重度组患者胰岛素样生长因子-1浓度减小,可溶性髓样细胞触发受体-1和髓鞘碱性蛋白浓度增加,差异均具有统计学意义（P〈0.05）;与常规治疗组比较,脑苷肌肽治疗后,有效率从70.18%升高到89.47%,脑脊液中胰岛素样生长因子-1含量由41.15±3.06ng/ml增大到52.04±3.53ng/ml,可溶性髓样细胞触发受体-1从95.01±9.63ng/ml下降为75.38±8.46ng/ml、髓鞘碱性蛋白含量从17.55±6.07ng/ml减小为12.01±5.16ng/ml,差异比较均具有统计学意义（P〈0.05）。结论：脑脊液中可溶性髓样细胞触发受体-1、胰岛素样生长因子-1、髓鞘碱性蛋白水平的变化与疾病的严重程度相关,提示可作为新生儿缺氧缺血脑病早期辅助诊断的可靠指标;脑苷肌肽对高原地区新生儿缺氧缺血脑病疗效显著,可减轻脑细胞损伤,值得临床推广使用。

Objective： To investigate the clinical efficacy and the s ICAM-1,IGF-1,MBP levels in cerebrospinal fluid of cattle encephalon glycoside and ignotin（ CEGI） treatment for hypoxic ischemic encephalopathy（ HIE） in plateau region. Methods： 114 cases of neonatal HIE in department of pediatrics of our hospital from February,2011 to June,2014 were randomly divided into conventional treatment group and CEGI group,30 cases of healthy newborn were chosed as control group. The CEGI group were treated with 10 ml CEGI injection once a day on the basis of conventional therapy,and the course of treatment was 2 weeks. The total effective rates and the s ICAM-1,IGF-1,MBP levels in cerebrospinal fluid were compared. Results： The IGF-1 level was statistically significantly lower in moderate HIE group and severe HIE group than that in control group（ P〈0. 05）,while the s ICAM-1 and MBP levels were higher in moderate HIE group and severe HIE group than those in control group（ P〈0. 05）. Compared with the mild HIE group,the s ICAM-1 and MBP levels increased significantly,and the concentration of IGF-1 decreased significantly in moderate HIE group and severe HIE group,the differences of them were statistically significant（ P〈0. 05）. Compared with conventional treatment group,the efficiency rate of CEGI group was significantly higher,the value was from 70.18% to 89. 47%,and the changes of ICAM-1,IGF-1,MBP levels in cerebrospinal fluid in CEGI group were more obvious,there were statistically significant differences（ P〈0. 05）. Conclusion： The change of s ICAM-1,IGF-1,MBP levels in cerebrospinal fluid of neonatal HIE patients are correlated with severity of the disease,which can be used as reliable indexes for early auxiliary diagnosis of HIE. Cattle encephalon glycoside and ignotin for the treatment of HIE in plateau region has a significant clinical effect,it can reduce brain cells injury and and worth of widely used.