单唾液酸四己糖神经节苷脂联合胞磷胆碱治疗新生儿缺氧缺血性脑病的临床分析

Clinical analysis of neonatal hypoxic-ischemic encephalopathy treated with ganglioside and citicoline

目的分析神经营养类药物单唾液酸四己糖神经节苷脂(monosialotetrahexosylganglioside,GM1)与胞磷胆碱(citicoline)联合使用在新生儿缺血缺氧性脑病(neonatal hypoxic-ischemic encephalopathy,NHIE)的临床疗效并探讨其可能的作用机制。方法收集2014年1月—2017年6月在广州市第一人民医院新生儿病房住院的54例新生儿缺血缺氧性脑病患儿的临床资料,将收集到的患儿随机分为2组,对照组27例,治疗组27例。治疗组与对照组的治疗的不同在于前者予以单唾液酸四己糖神经节苷脂GM1联合胞磷胆碱治疗,而对照组仅用单唾液酸四己糖神经节苷脂GM1,无用胞磷胆碱。治疗三个疗程后,比较2组用药前后的临床表现、神经功能评分及MRI变化情况。结果治疗组中临床总有效24例(88.9%);对照组中总有效17例(63.0%)(P<0.05);经过三个疗程后2组的神经功能评分均有上升,且治疗组的效果更明显(P<0.05);MRI检查示2组较用药前病灶范围减少,水肿减轻,治疗组改善更明显(P<0.05)。即经过三个疗程治疗后,两组患儿病情均有好转,且治疗组疗效更明显。结论神经营养类药物GM1联合胞磷胆碱通过修复、重构神经元、改善其代谢等促进受损的神经功能的恢复,在新生儿缺血缺氧性脑病的应用中具有良好的疗效。

Objective To analysis the clinical therapeutic effect of monosialotetrahexosylganglioside and citicolineon neonatal hypoxic-ischemic encephalopathy,and explore its possible mechanism.Methods A total of 54 newborn with hypoxicischemic encephalopathy were enrolled from January 2015 to June 2017 in Guangzhou First People s Hospital,and they were divided into control group and treatment group according to the treatment methods,with 27 cases in the control group and 27 cases in the treatment group.Both groups were treated with conventional treatment,the control group added gangliosides,and the treatment group used ganglioside and citicoline.The clinical effects,neurological score and MRI were observed in the two groups.Results The total effective rate was 88.9%in the treatment group,which was higher than 73.0%in the control group(P<0.05).There was no significant difference on neurological score between the two groups before treatment(P>0.05).After treatment,the neurological scores of the two groups were significantly improved,and the score of the treatment group was higher than that of the control group(P<0.05).MRI examinations found that the lesions were significantly improved in the two groups after treatments,and the effect of the treatment group was higher than that of the control group(P<0.05).Conclusion Monosialotetrahexosylganglioside combined with citicolineinthe in treatment of newborn with hypoxicischemic encephalopathy has good effects through repairing and rebuilding the neurons,improving the metabolism to promote the recovery of neurological functions.