富氢水在新生儿缺氧缺血性脑病中的应用效果

Therapeutic effect of hydrogen-rich water on neonatal hypoxic-ischemic encephalopathy

目的观察富氢水治疗新生儿缺氧缺血性脑病的临床效果。方法选取黄石市妇幼保健院2017年2月至2020年1月收治的60例新生儿缺氧缺血性脑病患儿,按随机数字表法分为常规治疗组(30例)和富氢水治疗组(30例)。常规治疗组接受保持气道通畅、必要时进行氧罩吸氧或机械通气、维持血压和血糖及血气等在正常范围、维持电解质平衡、控制抽搐、治疗脑水肿、保护神经、限制饮水量等常规治疗;富氢水治疗组在常规治疗的基础上接受口服氢水治疗,共10天,每日剂量为5mL/kg。观察两组患儿症状体征、治疗前后神经元特异性烯醇化酶(NSE)、白细胞介素-6(IL-6)、视椎蛋白样蛋白-1(VILIP-1)、肿瘤坏死因子-α(TNF-α)水平的变化情况,以及新生儿行为神经测定(NBNA)评分和不良反应发生情况。结果治疗10天后,富氢水治疗组前囟张力恢复正常时间、肌张力恢复正常时间、原始反射恢复正常时间、惊厥控制时间、意识障碍恢复正常时间及住院时间均较常规治疗组显著缩短(t=2.3164.594,P<0.05)。常规治疗组和富氢水治疗组内,治疗10天后NSE、IL-6、VILIP-1、TNF-α水平均显著低于治疗前(t=2.0104.951,P<0.05);治疗10天后,富氢水治疗组NSE、IL-6、VILIP-1、TNF-α水平均显著低于常规治疗组(t=1.8456.326,P<0.05)。常规治疗组和富氢水治疗组内,在治疗3天及10天后,NBNA评分较治疗前均显著增高,且治疗10天后NBNA评分均显著高于治疗3天后(t=1.9553.011,P<0.05);治疗3天和10天后,富氢水治疗组NBNA评分均显著高于常规治疗组(t值分别为4.504、4.819,P<0.05)。两组皮疹、腹泻、肝功能异常、低血压及总不良反应发生率差异均无统计学意义(P>0.05)。结论富氢水可提高新生儿缺氧缺血性脑病的治疗效果,安全性较高,富氢水可能通过降低新生儿缺氧缺血性脑病炎症水平发挥保护作用。

Objective To observe therapeutic effect of hydrogen-rich water on neonatal hypoxic-ischemic encephalopathy(HIE).Methods Sixty neonates with HIE who were treated in our hospital from February 2017 to January 2020 were selected and they were divided into conventional treatment group(30 cases) and hydrogen-rich water treatment group(30 cases) in random number table method.The neonates in the conventional treatment group received conventional treatment including keeping respiratory tract clear,giving mask oxygen inhalation or mechanical ventilation if necessary,maintaining blood ressure,blood glucose and blood gass at the normal levels,maintaining balance of electrolytes,controlling tic,treating cerebral edema,giving neuroprotective treatment,limiting daily water intake and so on,and those neonates in the hydrogen-rich water treatment group were treated with 5 mL/kg/day of hydrogen-rich water for 10 days on basis of conventional treatment.The symptoms and signs,serum levels of neuron specific enolase(NSE),interleukin-6(IL-6),Opsin-like protein-1(VILIP-1) and tumor necrosis factor-α(TNF-α) before and after treatment,NBNA scores and occurrence of adverse reactions were observed and compared between the two groups.Results After 10 days of treatment,the anterior fontanel tension recovery time,muscular tension recovery time,original reflex recovery time,convulsion controlling time and normal consciousness recovery time,and length of hospitalization of the neonates in the hydrogen-rich water treatment group were all shorter than those in the conventional treatment group(t=2.316~4.594,all P<0.05).There were no significant differences in NSE,IL-6,VILIP-1,TNF-α levels and NBNA scores between the two groups before treatment(all P> 0.05).After 10 days of treatment,the serum levels of NSE,IL-6,VILIP-1 and TNF-α of the neonates in the two groups were lower than those before treatment(t=2.010~4.951,all P<0.05).After 10 days of treatment,the serum levels of NSE,IL-6,VILIP-1 and TNF-α of the neonates in the hydrogen-rich water treatment group were lower than those in the conventional treatment group(t=1.845~6.326,all P<0.05).After 3 days and 10 days of treatment,the NBNA scores of the neonates in the two groups were both significantly higher than those before treatment,and that of the neonates after 10 days of treatment was significantly higher than that after 3 days of treatment(t=1.955~3.011,all P<0.05).After 3 days and 10 days of the treatment,the NBNA scores of the neonates in the hydrogen-rich water treatment group were both significantly higher than those in the conventional treatment group(t=4.504 and 4.819 respectively,both P<0.05).There were no significant differences in incidences of skin rash,diarrhea,abnormal liver function,hypotension and total adverse reactions between the two groups(all P>0.05).Conclusion Hydrogen-rich water can improve therapeutic effect on neonatal HIE and has high safety.Hydrogen-rich water may play a protective role by reducing inflammation level in neonatal HIE.