单唾液酸四己糖神经节苷脂钠联合亚低温对新生儿HIE血清炎症因子、神经损伤及神经行为的影响

Effects of monosialotetrahexosylganglioside sodium combined with mild hypothermia on serum inflammatory factors,nerve injury and neurobehavior in neonates with HIE

目的探讨单唾液酸四己糖神经节苷脂钠联合亚低温对新生儿缺氧缺血性脑病(HIE)血清炎症因子、神经损伤及神经行为的影响。方法选取海南现代妇女儿童医院收治的84例新生儿HIE,随机分为对照组(单唾液酸四己糖神经节苷脂钠治疗)和联合组(单唾液酸四己糖神经节苷脂钠+全身亚低温治疗),两组各42例,比较两组治疗前后血清炎症因子、神经损伤标志物及神经行为测定评分的差异。结果治疗后两组患儿血清白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)的含量均低于治疗前(P<0.05),且治疗后联合组患儿血清IL-1β、IL-6及TNF-α的含量均低于对照组(t值分别为4.982、5.894、5.791,P<0.05);治疗后两组患儿血清S100β蛋白、神经元特异性烯醇化酶(NSE)及髓磷脂碱性蛋白(MBP)的含量均降低(P<0.05),且治疗后联合组均低于对照组(t值分别为6.736、7.626、7.942,P<0.05);治疗后两组患儿神经行为测定评分均增高(P<0.05),且治疗后联合组的神经行为测定评分高于对照组(t=5.191,P<0.05);两组治疗期间均未发生药物及亚低温不耐受或其他不良反应。结论在单唾液酸四己糖神经节苷脂钠静脉滴注治疗的同时,联合应用全身亚低温疗法可有效改善新生儿HIE血清促炎因子的水平,减轻神经损伤,改善神经行为。

Objective To investigate effects of monosialotetrahexosylganglioside sodium combined with mild hypothermia on serum inflammatory factors, nerve injury and neurobehavior of neonates with hypoxic ischemic encephalopathy(HIE).Methods A total of 84 neonates with HIE admitted to the Hainan Modern Women and Children′s Hospital were randomly divided into the control group(monosialotetrahexosylganglioside sodium treatment) and the combination group(monosialotetrahexosylganglioside sodium treatment and systemic mild hypothermia treatment).There were 42 cases in each group.The differences in serum inflammatory factors, nerve injury markers and neurobehavioral measurement scores before and after treatment were compared between the two groups.Results After treatment, the levels of serum interleukin-1β(IL-1β),interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) in the two groups were significantly lower than those before treatment(P<0.05),and the levels of serum IL-1β,IL-6 and TNF-α in the combined group were significantly lower than those in the control group(t=4.982,5.894 and 5.791,respectively, P<0.05).After treatment, the contents of serum S100β protein, neuron-specific enolase(NSE) and myelin basic protein(MBP) of the two groups were significantly reduced(P<0.05),and those in the combined group were significantly lower than the control group after treatment(t=6.736,7.626 and 7.942,respectively, P<0.05).The neurobehavioral measurement scores of the two groups were significantly higher after treatment(P<0.05),and the behavior measurement score in the combined group was significantly higher than that of the control group(t=5.191,P<0.05).There was no drug and mild hypothermia intolerance or other adverse reactions during the treatment of the two groups.Conclusion In addition to the intravenous infusion of monosialotetrahexosylganglioside sodium, the combined application of systemic mild hypothermia therapy can effectively improve the level of serum pro-inflammatory factors in newborn with HIE,reduce nerve injury, and improve neurological behavior.