NGF、纳洛酮联合促红细胞生成素对新生儿缺氧缺血性脑病预后及PDCD5、8-OHDG表达的影响

Effect of combination therapy of NGF and naloxone on prognosis and expression of PDCD5 and hs-CRP in neonates with hypoxic ischemic encephalopathy

目的探究神经生长因子(nerve growth factor,NGF)、纳洛酮联合促红细胞生成素治疗新生儿缺血缺氧性脑病的治疗效果,以及其对程序性细胞死亡蛋白5(programmed cell death 5,PDCD5)和8-羟基脱氧鸟苷(8-hydroxy-2 deoxyguanosine,8-OHDG)水平变化的影响。方法选取新生儿缺血缺氧性脑病患儿90例,按随机数字表法分为观察组和对照组各45例。对照组采用纳洛酮联合NGF治疗,观察组在对照组基础上联合促红细胞生成素治疗。检测并记录两组意识恢复时间、惊厥消失时间、肌张力恢复时间、反射恢复时间,比较两组新生儿神经行为测定(neonatal behavioral neurological assessment,NBNA)评分、血清PDCD5和8-OHDG水平。评估两组治疗1年后智力发育指数(mental derelopmental index,MDI)及心理运动发育指数(psycho-moter developmental index,PDI)。记录两组治疗期间出现的不良反应发生情况。结果观察组总有效率为91.1%,对照组为73.3%,观察组治疗有效率高于对照组(P<0.05)。观察组意识恢复时间、惊厥消失时间、肌张力恢复时间、反射恢复时间等均显著短于对照组(P<0.01)。治疗后,两组NBNA评分较治疗前均显著升高(P<0.01),观察组NBNA评分显著高于对照组(P<0.01)。治疗后,两组PDCD5和8-OHDG较治疗前均显著降低(P<0.01),观察组PDCD5和8-OHDG均显著低于对照组(P<0.01)。观察组治疗1年后MDI和PDI均高于对照组(P<0.05)。两组治疗期间均未出现严重不良反应。结论NGF、纳洛酮联合促红细胞生成素治疗能够降低PDCD5和8-OHDG表达,减少脑组织损伤,抑制细胞凋亡,改善神经功能,促进患儿心理和运动发育。

Objective To investigate the therapeutic effect of nerve growth factor(NGF),naloxone combined with erythropoietin(EPO)in the treatment of neonatal hypoxic-ischemic encephalopathy(HIE),and their effects on the levels of programmed cell death 5(PDCD5)and 8-hydroxy-2-deoxyguanosine(8-OHdG).Methods A total of 90 cases of neonatal hypoxic ischemic encephalopathy were randomly divided into observation group and control group,45 cases in each group.The patients in the control group were treated with naloxone combined with NGF,and the patients in the observation group were treated with erythropoietin on the basis of the therapeutic method of the control group.The recovery time of consciousness,convulsion disappearance,muscle tension recovery and reflex recovery were detected and recorded.The neonatal neurobehavioral assessment(NBNA)score,serum PDCD5 and 8-OHdG levels were compared between the two groups.The mental retardation index(MDI)and psychomotor development index(PDI)of the two groups were evaluated after one year of treatment.The incidence of adverse reactions during the treatment of the two groups were recorded.Results The total effective rate of the observation group was 91.1%,and that of the control group was 73.3%.The effective rate of the observation group was higher than that of the control group(P<0.05).The recovery time of consciousness,convulsion disappearance,muscle tension recovery and reflex recovery in the observation group were significantly shorter than those in the control group(P<0.01).After treatment,the NBNA scores of the two groups were significantly increased(P<0.01),and the NBNA score of the observation group was significantly higher than that of the control group(P<0.01).After treatment,PDCD5 and 8-OHdG in the two groups were significantly lower than those before treatment(P<0.01),while PDCD5 and 8-OHdG in the observation group were significantly lower than those in the control group(P<0.01).The MDI and PDI of the observation group were higher than those of the control group after 1 year of treatment(P<0.05).There were no serious adverse reactions in both groups.Conclusion NGF combined with naloxone can reduce the expression of PDCD5 and 8-OHDG,which can reduce brain tissue damage and inhibit cell apoptosis,improve neurological function and promote psychological and motor development of children.