高压氧治疗对缺氧缺血性脑病患儿的疗效及细胞因子水平的变化研究

Study on the curative effect and cytokine level of hyperbaric oxygen therapy in children with hypoxic-ischemic encephalopathy

目的:研究高压氧治疗对缺氧缺血性脑病患儿的疗效及细胞因子水平的变化影响。方法:选取我院2013-01~2017-12收治的缺氧缺血性脑病患儿100例,根据治疗方法分为对照组(对症支持治疗)和观察组(高压氧联合支持治疗)。比较两组疗效、症状恢复时间、住院时间及细胞因子、新生儿神经行为测定(NBNA)评分。结果:观察组总有效率高于对照组(P<0.05)。观察组意识状态恢复时间(3.69±1.41)d、神经反射恢复时间(3.84±1.55)d及住院时间(15.77±5.01)d短于对照组(P<0.05)。两组治疗前肌酸激酶同工酶(CK-MB)、神经元特异性烯醇酶(NSE)、核因子-κB(NF-κB)、血清8-羟基脱氧鸟苷(8-OHDG)水平比较,差异无统计学意义(P>0.05)。观察组治疗后CK-MB水平高于对照组,NSE、NF-κB、8-OHDG水平低于对照组(P<0.05)。两组治疗前(NBNA评分组间比较,无统计学意义(P>0.05)。观察组治疗后NBNA评分(38.45±4.11)分高于对照组(P<0.05)。结论:高压氧治疗新生儿缺氧缺血性脑病疗效明显,可调节CK-MB、NSE、NF-κB、8-OHDG的表达水平,加快意识状态和神经反射的恢复,缩短住院时间。

Objective:To study the effect of hyperbaric oxygen therapy on children with hypoxic-ischemic encephalopathy and the effect of changes in cytokine levels.Methods:A total of 100 children with hypoxic-ischemic encephalopathy admitted to our hospital(January 2013 to December 2017)were selected and divided into control group(symptomatic and supportive treatment)and observation group(hyperbaric oxygen combined supportive treatment)according to different treatment methods).The curative effect,symptom recovery time,hospitalization time,cytokine,and neonatal neurobehavioral measurement(NBNA)score were compared between the two groups.Results:The total effective rate of the observation group was higher than that of the control group(P<0.05).The recovery time of consciousness state(3.69±1.41)d,nerve reflex recovery time(3.84±1.55)d and hospitalization time(15.77±5.01)d in the observation group were shorter than those in the control group(P<0.05).The levels of creatine kinase isoenzyme(CK-MB),neuron-specific enolase(NSE),nuclear factor-κB(NF-κB)and serum 8-hydroxydeoxyguanosine(8-OHDG)before treatment in the two groups The comparison between groups was not statistically significant(P>0.05).After treatment,the CK-MB level of the observation group was higher than that of the control group,and the levels of NSE,NF-κB,and 8-OHDG were lower than the control group(P<0.05).Before treatment of the two groups(the comparison of NBNA scores between groups,there was no statistical significance(P>0.05).After treatment,the NBNA score of the observation group(38.45±4.11)was higher than that of the control group(P<0.05).Conclusion:Hyperbaric oxygen treatment of neonatal hypoxia Oxygen-ischemic encephalopathy has obvious curative effect.It can adjust the expression levels of CK-MB,NSE,NF-κB,8-OHDG,speed up the recovery of consciousness and nerve reflexes,and shorten the hospital stay.