高压氧对缺氧缺血性脑病新生儿血清抗氧化物质及脑功能指标的影响

Effects of hyperbaric oxygen on serum levels of antioxidant in neonates with hypoxic ischemic encephalopathy

目的：探讨高压氧治疗对缺氧缺血性脑病（ HIE）新生儿血清丙二醛（ MDA）、超氧化物歧化酶（ SOD）、神经元特异性烯醇化酶（ NSE）及血清髓鞘碱性蛋白（ MBP）水平的影响。方法90例HIE足月新生儿，按治疗方法分为高压氧组45例，常规治疗组45例，选取同期出生的正常新生儿45例为正常对照组。在治疗前后分别用酶联免疫分析法及化学比色法检测血清MDA、SOD、NSE、MBP水平。评估患儿治疗前后行为神经评分（ NBNA）变化，并分析NBNA与以上指标的相关性。结果 HIE患儿治疗前MDA、NSE、MBP水平明显高于正常对照组[（4．48±0．94） nmol／L、（10．02±3．10）μg／L、（4．58±2．17）μg／L]（P＜0．05），SOD明显低于正常对照组[（137．65±34．54）μU／L]（P＜0．05）；高压氧组和常规治疗组治疗后血清SOD上升，MDA、NSE、MBP下降，NBNA评分升高，较同组治疗前差异有统计学意义（P＜0．05）；高压氧组中／重度HIE患儿上述指标变化更明显，与相同程度常规治疗组比较差异有统计学意义（P＜0．01）；MBP与NBNA之间具有相关性。结论高压氧治疗提高HIE患儿抗氧化能力，降低脑组织脂质过氧化反应损伤，联合检测MDA、SOD、NSE和MBP有利于病情的评估和判断。

Objective To explore the effects of hyperbaric oxygen （ HBO） therapy on the serum levels of malondialdehyde （MDA）, superoxide dismutase （SOD） , neuron specific enolase （NSE） and myelin basic protein （MBP） in neonates with hypoxic ischemic encephalopathy （HIE）.Methods Ninety neonates with HIE were randomly divided into the HBO group （ n=45 ） and the conventional treatment group （ n =45 ） . Another 45 normal neonates borns at the same time were chosen as the control group .Serum levels of MDA , SOD, NSE and MBP were detected with enzyme immunoassay and chemical colorimetric assay , both before and after treatment.Changes in the scores of NBNA were evaluated both before and after treatment , and the relationship between NBNA and the above data was analyzed .Results Before HBO therapy , the MDA, NSE and MBP levels in the neonates with HIE were obviously higher than those of the control group （ P〈0.05） [（4.48 ±0.94）nmol/L、（10.02 ±3.10）μg/L、（4.58 ±2.17）μg/L], and the level of SOD was noticeably lower that of the control group （P〈0.05）[（137.65 ±34.54）μU/L].Following HBO therapy, the levels of SOD for the HBO group and the routine treatment group were increased , while the levels of MDA , NSE and MBP were decreased , and the scores of NBNA were elevated .Statistical significance could be noted , when compared with those before treatment （P〈0.05）.More significant changes in the above parameters could be noted in the moderate and severe patients of the HBO group , and statistical significance could be found , when compared with those of the routine treatment group （P〈0.01）.Results showed that the levels of MBP and NBNA were well correlated .Conclusions HBO therapy could improve the antioxidant capacity of the neonates＆nbsp;with HIE and decrease lesion induced by brain tissue lipid peroxidation .Combined detection of MDA , SOD, NSE and MBP was beneficial to the assessment and judgment of the patients＇conditions .