鼠神经因子联合磷酸肌酸钠在新生儿HIE中的应用

Application of Rat Neural Factor Combined with Creatine Phosphate in Neonatal HIE

目的:探究鼠神经生长因子(M-NGF)联合磷酸肌酸钠治疗新生儿缺氧缺血性脑病(HIE)的临床效果。方法:选取2017年6月至2018年12月本院收治的新生儿HIE患儿62例,按简单随机数字表法分为两组,各31例。对照组患儿给予常规治疗,研究组在对照组基础上采用M-NGF联合磷酸肌酸钠治疗,均连续治疗10d。比较两组新生儿行为神经评分(NBNA)、心肌指标(cTnI、CK-MB、CK)、临床疗效、安全性。结果:重复测量方差分析显示,两组NBNA评分、心肌指标的时点、组间、时点与组别的交互效应差异有统计学意义(P<0.05)。组内成对比较结果显示,两组患者不同时点NBNA评分且呈明显的上升趋势(P<0.05),cTnI、CK-MB、CK均呈明显的下降趋势(P<0.05)。组间成对比较结果显示,治疗前,两组NBNA评分、心肌指标水平比较差异无统计学意义(P>0.05);治疗5d、10d,研究组NBNA评分高于对照组,cTnI、CK-MB、CK均低于对照组,差异有统计学意义(P<0.05)。研究组治疗总有效率(96.77%)高于对照组(70.97%),差异有统计学意义(χ^2=7.631,P<0.05)。两组患儿治疗过程均未发生严重不良反应。结论:M-NGF联合磷酸肌酸钠治疗新生儿HIE可明显改善心肌功能,减少心肌损伤,促进神经功能恢复,提高临床疗效,且安全性高。

Objective:To investigate the clinical effects of murine nerve growth factor(M-NGF)combined with sodium creatine phosphate in the treatment of neonatal hypoxic ischemic encephalopathy(HIE).Methods:From June 2017 to December 2018,62 neonates with HIE were simple random number table method divided into two groups(31 cases each).The children in the control group were treated with routine treatment,and the study group was treated with M-NGF combined with creatine phosphate on the basis of the control group for 10 days.Neonatal behavioral nerve score(NBNA),myocardial markers(cTnI,CK-MB,CK),clinical efficacy,and safety were compared between the two groups.Results:Repeated measurement analysis of variance showed that there were significant differences in NBNA score,myocardial between the two groups,and the interaction between the two groups(P<0.05).The results of pairwise comparison within the group showed that the NBNA scores at different time points in the two groups showed a significant upward trend(P<0.05),and cTnI,CK-MB and CK all showed a significant downward trend(P<0.05).Coupled comparisons between groups showed,before treatment,there was no significant difference in NBNA score,myocardial between the two groups(P>0.05).On the 5th and 10th day of treatment,the NBNA score in the study group were higher than those in the control group,and the cTnI,CK-MB,CK levels were lower than those in the control group(P<0.05).The total effective rate of treatment in the study group(96.77%)was higher than that in the control group(70.97%),the difference was statistically significant(χ^2=7.631,P<0.05).There were no serious adverse reactions during treatment in both groups.Conclusion:M-NGF combined with creatine phosphate in the treatment of neonatal HIE can significantly improve myocardial function,reduce myocardial injury,promote the recovery of nerve function,improve the clinical efficacy,and has high safety.