亚低温联合EPO治疗对新生儿缺氧缺血性脑病脑损伤、心肌损伤及氧化应激的影响

Effects of mild hypothermia combined EPO therapy on cerebral injury,myocardial injury and oxidative stress of neonatal hypoxic ischemic encephalopathy

目的:探讨亚低温联合促红细胞生成素(EPO)治疗对新生儿缺氧缺血性脑病脑损伤、心肌损伤及氧化应激的影响。方法:2015年12月~2017年6月间本院确诊并进行治疗的HIE患儿72例作为研究对象,参照随机数表法分为对照组、EPO组各36例。对照组患儿在常规治疗基础上加入亚低温治疗,EPO组患儿在对照组治疗基础上加入EPO治疗。对比两组患儿治疗前后血清脑损伤指标、心肌损伤指标、氧化应激指标含量的差异。结果:治疗前,两组血清中脑损伤指标、心肌损伤指标、氧化应激指标含量的差异无统计学意义(P>0.05)。治疗结束后,EPO组血清中脑损伤指标视椎蛋白样蛋白1(VILIP-1)、神经肽Y(NPY)、神经元特异性烯醇化酶(NSE)含量低于对照组,胰岛素生长因子1(IGF-1)的含量高于对照组;心肌损伤指标心肌营养因子-1(CT-1)、肌红蛋白(Myo)、心肌肌钙蛋白Ⅰ(cTnⅠ)含量低于对照组;氧化应激指标谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)含量高于对照组,晚期蛋白氧化产物(AOPP)、活性氧(ROS)含量低于对照组(P<0.05)。结论:亚低温联合EPO治疗对新生儿缺氧缺血性脑病脑损伤、心肌损伤及氧化应激具有改善作用。

Objective：To explore the effects of mild hypothermia combined EPO therapy on cerebral injury,myocardial injury and oxidative stress of neonatal hypoxic ischemic encephalopathy.Methods：72 children with HIE who were diagnosed and treated in the hospital between December 2015 and June 2017 were chosen as the study subjects and divided into control group（n=36）and EPO group（n=36）by random number table method.Control group received mild hypothermia therapy on the basis of conventional therapy,and EPO group received EPO therapy on the basis of the therapy for control group.The differences in serum levels of cerebral injury indexes,myocardial injury indexes and oxidative stress indexes were compared between the two groups before and after treatment.Results：The differences in serum levels of cerebral injury indexes,myocardial injury indexes and oxidative stress indexes were not statistically significant between the two groups before treatment（P〉0.05）.After the treatment ended,serum cerebral injury indexes VILIP-1,NPY and NSE levels of EPO group were lower than those of control group whereas IGF-1 level was higher than that of control group;myocardial injury indexes CT-1,Myo and cTn Ⅰlevels were lower than those of control group;oxidative stress indexes GSH-Px and SOD levels were higher than those of control group whereas AOPP and ROS levels were lower than those of control group（P〈0.05）.Conclusion：Mild hypothermia combined with EPO therapy can improve the cerebral injury,myocardial injury and oxidative stress of neonatal hypoxic ischemic encephalopathy.