鼠神经生长因子治疗新生儿缺氧缺血性脑病合并心肌损伤的疗效分析

Therapeutic efficacy of rat nerve growth factor in neonatal hypoxic-ischemic encephalopathy combined with myocardial injury

目的探讨新生儿缺氧缺血性脑病(HIE)合并心肌损伤应用鼠神经生长因子(NGF)治疗的临床效果。方法选取2013年3月—2017年1月河北省儿童医院收治HIE合并心肌损伤的78例新生儿,随机分为对照组与观察组,每组39例。对照组接受常规治疗,观察组接受鼠NGF治疗。疗程结束后,比较两组临床表现、实验室检查指标、新生儿行为神经测定(NBNA)及神经心理发育情况。结果接受不同治疗后,对照组治疗总有效率低于观察组(66.67%VS 87.18%)(P <0.05);观察组超氧化物歧化酶(SOD)水平高于对照组(P <0.05),而血管内皮生长因子(VEGF)、白细胞介素(IL-10)、肌酸激酶同工酶(CK-MB)及心肌肌钙蛋白I(CTn I)水平低于对照组(P<0.05);观察组治疗后第4、7及10天新生儿行为神经测定评分(NBNA)均高于对照组(P<0.05);观察组治疗后第3、6个月智力发育指数(MDI)水平与运动发育指数(PDI)水平均高于对照组(P <0.05)。结论 HIE合并心肌损伤患儿应用鼠NGF,能促进其中枢神经系统功能恢复、减少氧化应激损伤与炎症反应、改善心肌功能及降低后遗症发生。

Objective To study therapeutic effect of rat nerve growth factor(NGF)in neonatal hypoxicischemic encephalopathy(HIE)combined with myocardial injury(MI).Methods A total of 78 cases of neonatal HIE combined with MI admitted in Children's Hospital of Hebei Province from Mar.2013 to Jan.2017 were enrolled in the study,and were randomly divided into 2 groups.All patients received conventional treatment,and patients in observation group(39 cases)received additional intramuscular injection of NGF.Clinical manifestations,laboratory examination indexes,neonatal behavioral neurological assessment(NBNA)and neuropsychological development were recorded.Results Total effective rate in control group was significantly lower compared with observation group(66.67%vs 87.18%,P<0.05).Levels of superoxide dismutase(SOD)was increased while vascular endothelial growth factor(VEGF),IL-10,CK-MB and CTn I were decreased in the observation group when compared with those in control group(P<0.05).NBNA level was higher in observation group than control group at the 4th,7th and 10th day after treatment.Mental development index(MDI)and psycho-motive development index(PDI)at the 3rd and 6th week in the observation group were higher than those in the control group(P<0.05).Conclusions Rat NGF promotes functional recovery of nervous system and myocadiac in neonates with HIE combined with MI.