醒脑静注射液联合奥拉西坦治疗新生儿缺氧缺血性脑病的临床研究

Clinical study on Xingnaojing Injection combined with oxiracetam in treatment of neonatal hypoxic-ischemic encephalopathy

目的探讨醒脑静注射液联合奥拉西坦注射液治疗新生儿缺氧缺血性脑病的临床疗效。方法选取2019年6月—2021年7月林州市妇幼保健院收治70例新生儿缺氧缺血性脑病患儿,根据随机数字表法将70例患儿分为对照组和治疗组,每组各35例。对照组静脉滴注奥拉西坦注射液,1.0 g加入50 mL葡萄糖注射液稀释后缓慢滴注,1次/d。治疗组在对照组基础上静脉滴注醒脑静注射液,剂量0.5 mL/kg,1次/d。两组患儿连续治疗2周。观察两组的临床疗效,比较两组患儿神经行为功能、主要症状的恢复时间、血清高迁移率族蛋白B1(HMGB1)、胰岛素样生长因子(IGF-1)、缺氧诱导因子-1α(HIF1α)水平。结果治疗后,治疗组患儿的总有效率为97.14%,对照组的总有效率为82.86%,组间差异有统计学意义(P<0.05)。治疗后,两组的新生儿神经行为测定(NBNA)评分明显比治疗前高(P<0.05),且治疗组的NBNA评分比对照组高(P<0.05)。治疗后,治疗组患儿肌张力、意识、反射恢复时间均明显短于对照组(P<0.05)。治疗后,两组的血清HMGB1、HIF-1α水平显著减少,IGF-1水平显著增多(P<0.05);治疗组的血清HMGB1、HIF-1α水平比对照组低,IGF-1水平比对照组高(P<0.05)。结论醒脑静注射液联合奥拉西坦注射液治疗新生儿缺氧缺血性脑病的疗效确切,能显著改善临床症状和神经行为功能,调节HMGB1、IGF-1、HIF-1α的分泌,药物安全性良好。

Objective To investigate the clinical efficacy of Xingnaojing Injection combined with Oxiracetam Injection in treatment of neonatal hypoxic-ischemic encephalopathy.Methods Infants(70 cases)with neonatal hypoxic-ischemic encephalopathy in Linzhou Maternal and Child Health Hospital from June 2019 to July 2021 were randomly divided into control and treatment groups,and each group had 35 cases.Infants in the control group were iv administered with Oxiracetam Injection,1.0 g added into glucose Injection 50 mL,once daily.Infants in the treatment group were iv administered with Xingnaojing Injection on the basis of the control group,0.5 mL/kg,once daily.Infants in two groups were treated for 2 weeks.After treatment,the clinical efficacies were evaluated,and neurobehavioral function,the recovery time of main symptoms and signs,and the serum level of HMGB1,IGF-1,and HIF-1αin two groups were compared.Results After treatment,the total effective rate was 97.14%in the treatment group and 82.86%in the control group,and there was significant difference between the groups(P<0.05).After treatment,the NBNA score of two groups was significantly higher than that before treatment(P<0.05),and the NBNA score of the treatment group was higher than that of the control group(P<0.05).After treatment,the recovery time of muscle tension,consciousness,and reflex in the treatment group was significantly shorter than that in the control group(P<0.05).After treatment,the levels of HMGB1 and HIF-1αin two groups were significantly decreased,but the level of IGF-1 in two groups were significantly increased(P<0.05).The levels of HMGB1 and HIF1αin the treatment group were lower than those in the control group,but the level of IGF-1 in the treatment group was higher than those in the control group(P<0.05).Conclusion Xingnaojing Injection combined with Oxiracetam Injection is effective in the treatment of neonatal hypoxic-ischemic encephalopathy,can significantly improve clinical symptoms and neurobehavioral function,and regulate the secretion of HMGB1,IGF-1 and HIF-1α,with good safety.