高压氧联合神经节苷脂对缺血缺氧性脑病新生儿血清炎症因子和NSE、Bcl-2的影响

Effects of hyperbaric oxygen combined with gangliosides on serum inflammatory factors,NSE,and Bcl-2 in neonates with hypoxic ischemic encephalopathy

目的:探讨高压氧(HBO)联合神经节苷脂对缺血缺氧性脑病(HIE)新生儿血清炎症因子和神经元特异性烯醇化酶(NSE)、B淋巴细胞瘤-2(Bcl-2)蛋白的影响。方法:选取2019年1月至2021年1月济宁医学院附属医院收治的200例HIE新生儿,按照随机数字表法分为观察组和对照组各100例。在吸氧、降颅压等常规治疗基础上,对照组患儿接受神经节苷脂治疗,观察组患儿接受HBO联合神经节苷脂治疗。治疗2个疗程后,比较2组患儿的临床疗效及血清炎症因子和NSE、Bcl-2变化。结果:观察组患儿治疗1、2、3周时的总有效率均高于对照组,差异有统计学意义(P<0.05);观察组患儿各临床症状消失时间均短于对照组,差异有统计学意义(P<0.05)。治疗前,2组患儿血清超敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、NSE、Bcl-2水平差异无统计学意义(P>0.05)。治疗1、2、3周时,2组患儿血清hs-CRP、TNF-α、IL-6、NSE、Bcl-2水平均低于治疗前,且观察组患儿血清各指标水平均低于对照组,差异有统计学意义(P<0.05)。随访1、3个月,观察组患儿血清NSE、Bcl-2水平均低于对照组,差异有统计学意义(P<0.05);观察组患儿后遗症总发生率低于对照组,差异有统计学意义(P<0.05)。结论:HBO联合神经节苷脂治疗HIE患儿有助于提高疗效,降低机体血清炎症因子和NSE、Bcl-2水平,缩短临床症状消失时间,改善患儿预后,具有重要的临床应用价值。

Objective:To explore the effects of hyperbaric oxygen(HBO)combined with gangliosides on serum inflammatory factors,NSE,and Bcl-2 in neonates with hypoxic ischemic encephalopathy(HIE).Methods:A total of 200 neonates with HIE admitted to the Affiliated Hospital of Jining Medical University from January 2019 to January 2021 were selected and divided into observation group and control group according to the random number table method,with 100 cases in each group.Based on conventional treatments such as oxygen inhalation and intracranial pressure reduction,the control group was treated with ganglioside,and the observation group was treated with HBO combined with ganglioside treatment.After two courses of treatment,the clinical efficacy and the changes of serum inflammatory factors,NSE,and Bcl-2 were compared between the two groups.Results:The total effective rate of the observation group was significantly higher than that of the control group at 1,2,and 3 weeks after treatment and the difference was statistically significant(P<0.05).The disappearance time of clinical symptoms of the observation group was shorter than that of the control group,and the difference was statistically significant(P<0.05).There was no significant differences in the serum levels of hypersensitivity C-reactive protein(hs-CRP),tumor necrosis factor alpha(TNF-α),interleukin 6(IL-6),NSE,and Bcl-2 between the two groups before treatment(P>0.05).At 1,2,and 3 weeks after treatment,the serum levels of hs-CRP,TNF-α,IL-6,NSE,and Bcl-2 of the two groups were significantly lower than those before treatment,and the serum levels of all indexes of the observation group were significantly lower than those of the control group,and the differences were statistically significant(P<0.05).The serum levels of NSE and Bcl-2 of the observation group were lower than those of the observation group at 1 and 3 months of follow-up,and the differences were statistically significant(P<0.05).The total incidence of sequelae of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion:HBO combined with gangliosides in the treatment of neonates with HIE can improve the curative effect,reduce the serum levels of inflammatory factors,NSE,and Bcl-2,shorten the disappearance time of clinical symptoms,and improve the prognosis of neonates,which has important clinical application value.