丹参酮ⅡA磺酸钠联合盐酸纳洛酮对缺氧缺血性脑病患儿神经系统损伤的改善研究

Effect of tanshinone ⅡA combined with naloxone on nerve injury in neonates with hypoxic-ischemic encephalopathy

目的观察丹参酮ⅡA磺酸钠注射液与盐酸纳洛酮注射液联合用药对缺氧缺血性脑病患儿神经损伤的改善作用。方法 2011年1月至2013年2月朝阳市第二医院儿科收治住院的缺氧缺血性脑病新生儿66例,随机分为丹参酮+纳洛酮组、纳洛酮组、对照组各22例。对照组患儿采用支持治疗和对症处理,纳洛酮组在对照组治疗基础上加用纳洛酮治疗,一般用药5~7d。丹参酮+纳洛酮组在纳洛酮组治疗基础上给予复方丹参酮ⅡA治疗,疗程10~14d。于治疗前和治疗结束时进行新生儿行为神经评分评估,并检测血清神经元特异性烯醇化酶水平。结果与治疗前比较,治疗后各组新生儿行为神经测定评分有不同程度提高,神经元特异性烯醇化酶水平有不同程度下降,其中以丹参酮+纳洛酮组作用最为明显,差异有统计学意义(P<0.01)。治疗后各组间比较,丹参酮+纳洛酮组新生儿行为神经测定评分最高,神经元特异性烯醇化酶水平最低,差异有统计学意义(P<0.01)。结论丹参酮ⅡA磺酸钠注射液与盐酸纳洛酮注射液治疗可明显减轻缺氧缺血性脑病致神经损伤。

Objective To investigate the effects of the combined use of tanshinoneⅡA and naloxone on nerve injury in neonates with hypoxic-ischemic encephalopathy.Methods Sixty-six neonates with hypoxic-ischemic encephalopathy were equally randomized into tanshinone ⅡA plus naloxone,naloxone,and control groups.The conventional symptomatic treatment was given to the neonates in the three groups;theneonates in tanshinone ⅡA plus naloxone and naloxone groups were respectively given combined treatment for 10~14 days or naloxone treatment alone for 5~7days.Neurological scores were assessed at birth and at the end of treatment,and the serum levels of neuron specific enolase were determined.Results Compared with before treatment,the neurological scores were increased to different degrees,while the serum neuron specific enolase levels were decreased after treatment;those changes were the most obvious in the combined treatment group（P〈0.01）.After treatment,the neurological scores were the highest,while the serum neuron specific enolase levels were the lowest in the combined treatment group compared with the other two groups（P〈0.01）.Conclusion The use of tanshinone ⅡA plus naloxone in the treatment of hypoxic-ischemic encephalopathy can significantly attenuate nerve injury.