亚低温联合脑蛋白水解物治疗新生儿窒息脑损伤的临床研究及对血GFAP的影响

Clinical study of mild hypothermia combined with cerebroprotein hydrolysate in the treatment of neonatal asphyxia brain injury and its influence on blood GFAP

目的探讨亚低温联合脑蛋白水解物治疗新生儿窒息脑损伤的临床效果及对血胶质纤维酸性蛋白(GFAP)的影响。方法回顾性分析2018年5月—2020年5月华北石油管理局总医院新生儿科收治的81例新生儿窒息中重度脑损伤患儿,根据药物使用情况将其分为脑蛋白水解物组(40例)和亚低温联合脑蛋白水解物组(41例)。两组患儿均给予对症支持治疗如维持电解质平衡、降低颅内压、抗感染、静脉营养支持等。脑蛋白水解物组使用曲克芦丁脑蛋白水解物注射液;亚低温联合脑蛋白水解物组在脑蛋白水解物组的基础上联合头部亚低温治疗。比较两组患儿意识恢复、肌张力恢复、原始反射恢复时间及血GFAP水平。结果亚低温联合脑蛋白水解物组意识恢复、肌张力恢复、原始反射恢复时间短于脑蛋白水解物组(均P<0.05)。治疗前两组血GFAP水平比较,差异无统计学意义(P>0.05)。治疗7 d后,两组血GFAP水平高于治疗前和治疗3 d后;治疗3 d后两组血GFAP水平高于治疗前(均P<0.05)。治疗3、7 d后亚低温联合脑蛋白水解物组血GFAP水平低于脑蛋白水解物组(均P<0.05)。结论采用亚低温联合脑蛋白水解物治疗能明显改善新生儿窒息脑损伤患儿的临床表现,血GFAP检测有助于新生儿窒息脑损伤的预后判断。

Objective To observe the effect of mild hypothermia combined with cerebroprotein hydrolysate in the treatment of neonatal asphyxia brain injury and its influence on blood glial fibrillary acidic protein(GFAP).Methods Retrospective analysis was performed on 81 cases of neonatal asphyxia with moderate and severe brain injury admitted to Department of Neonatology,Huabei Petroleum Administration Bureau General Hospital from May 2018 to May 2020.According to the drug use,they were divided into cerebroprotein hydrolysate group(40 cases)and mild hypothermia combined with cerebroprotein hydrolysate group(41 cases).Two groups were given symptomatic support treatment,such as maintaining electrolyte balance,reducing intracranial pressure,anti infection,intravenous nutrition support,etc.Cerebroprotein hydrolysate group was treated with Trixerutin Brain Protein Hydrolysate Injection and mild hypothermia combined with cerebroprotein hydrolysate group was combined with head mild hypothermia treatment on the basis of cerebroprotein hydrolysate group.The consciousness recovery time,muscle tension recovery time,primary reflex recovery time and blood GFAP level were compared between two groups.Results The consciousness recovery time,muscle tension recovery time,primary reflex recovery time in mild hypothermia combined with cerebroprotein hydrolysate group were shorter than those in cerebroprotein hydrolysate group(all P<0.05).Before treatment,there was no significant difference in blood GFAP level between the two groups(P>0.05).After seven days of treatment,the blood GFAP level in both groups were higher than those before treatment and after three days of treatment.After three days of treatment,the blood GFAP level in both groups were higher than those before treatment(all P<0.05).After three,seven days of treatment,the blood GFAP level of the mild hypothermia combined with cerebroprotein hydrolysate group were lower than those of cerebroprotein hydrolysate group(all P<0.05).Conclusion Mild hypothermia combined with cerebroprotein hydrolysate can significantly improve the clinical manifestations of neonatal asphyxia brain injury and the detection of blood GFAP is helpful for the prognosis of neonatal asphyxia brain injury.