单唾液酸四己糖神经节苷脂钠注射液联合枸橼酸咖啡因治疗早产儿脑损伤的疗效及对血清S100-β、UCH-L1水平的影响

Efficacy of monosialotetrahexosylganglioside sodium injection combined with caffeine citrate in the treatment of brain injury in premature infants and itsimpacts on serum S100-β and UCH-L1 levels

目的 探讨单唾液酸四己糖神经节苷脂钠注射液联合枸橼酸咖啡因治疗早产儿脑损伤的疗效及对血清中枢神经特异性蛋白(S100-β)、泛素羧基末端水解酶-L1(UCH-L1)水平的影响。方法 选取在2021年3月至2023年6月在河北省承德市妇幼保健院分娩并接受治疗的82例早产脑损伤患儿作为研究对象,按照随机数字表法将其分为对照组和观察组,每组41例。所有患儿均进行常规基础治疗及护理,在此基础上对照组给予枸橼酸咖啡因治疗,观察组在对照组的基础上给予单唾液酸四己糖神经节苷脂钠注射液治疗。评估两组患儿的临床治疗效果、新生儿神经行为测定(NBNA)评分、Gesell发育诊断量表评分(主要包括适应行为、大运动行为、精细运动行为、语言行为及个人-社交行为评分),检测两组患儿血清S100-β、UCH-L1水平;记录并比较两组患儿的意识恢复时间、原始反射恢复时间、肌张力恢复时间、自主吮奶时间、住院时间及不良反应发生情况。结果 观察组患儿的总有效率为85.37%,明显高于对照组的58.54%(P<0.05)。重复测量方差分析结果显示,NBNA评分存在组间效应、时间效应和交互效应(P<0.05);治疗前,两组患儿NBNA评分比较,差异无统计学意义(P>0.05);治疗1、2周后,两组患儿的NBNA评分较治疗前显著升高(P<0.05),且观察组患儿的NBNA评分显著高于对照组(P<0.05)。治疗前,两组患儿Gesell发育诊断量表各项评分及血清S100-β、UCH-L1水平比较,差异均无统计学意义(P>0.05);治疗后,两组患儿Gesell发育诊断量表的各项评分高于治疗前,血清S100-β、UCH-L1水平低于治疗前,且观察组患儿Gesell发育诊断量表的各项评分显著高于对照组,S100-β、UCH-L1水平低于对照组,差异均有统计学意义(P<0.05)。观察组患儿的意识恢复时间、原始反射恢复时间、肌张力恢复时间、自主吮奶时间及住院时间均显著短于对照组(P<0.05)。观察组不良反应总发生率为4.88%,明显低于对照组的19.52%(P<0.05)。结论 单唾液酸四己糖神经节苷脂钠联合枸橼酸咖啡因可以促进患儿脑损伤神经功能修复,缩短患儿康复时间,促进患儿康复,且临床治疗效果良好,具有一定临床应用价值。

Objective To investigate the efficacy of monosialotetrahexosylganglioside sodium injection combined with caffeine citrate in the treatment of brain injury in premature infants and its impacts on serum central nervous system specific proteinβ(S100-β)and ubiquitin carboxyl terminal hydrolase-L1(UCH-L1)levels.Methods A total of 82 premature infants with brain injury,who were born and treated Chengde Maternal and Child Health Hospital from March 2021 to June 2023,were collected and divided into control group and observation group according to the random number table method,with 41 cases in each group.All children received routine basic treatment and nursing care,on the basis of which caffeine citrate was given to the control group,and monosialotetrahexosylganglioside sodium was given to the observation group on the basis of the control group.The clinical therapeutic effects,neonatal behavioral neurological assessment(NBNA)scores,Gesell Developmental Diagnostic Scale scores(mainly including adaptive behaviors,gross motor behaviors,fine motor behaviors,verbal behaviors,personal-social behaviors scores)in the two groups were assessed,and the serum levels of S100-β,UCH-L1 were tested in the two groups.The recovery times of consciousness,original reflex,muscle tone,autonomous breastfeeding,hospitalization and adverse reactions of the children in the two groups were recorded and compared.Results The total effective rate of the observation group was 85.37%,which was significantly higher than 58.54%of the control group(P<0.05).The repeated measurement variance analysis results showed that there were time effect,inter-group effect and interaction effect of NBNA score(P<0.05).Before treatment,there was no statistically significant difference on NBNA score between the two groups(P>0.05).After 1 and 2 weeks of treatment,the NBNA scores in the two groups were significantly higher than those before treatment(P<0.05),and the NBNA score in the observation group was significantly higher than that in the control group(P<0.05).Before treatment,there were no statistically significant differences in the scores of Gesell Developmental Diagnostic Scale and the levels of serum S100-βand UCH-L1 between the two groups(P>0.05);after treatment,the scores of Gesell Developmental Diagnostic Scale were higher than those before treatment,and the levels of serum S100-βand UCH-L1 were lower than those before treatment,moreover,the scores of Gesell Developmental Diagnostic Scale in the observation group were higher than those in the control group,and the levels of serum S100-βand UCH-L1 were lower than those in the control group,with statistically significant differences(P<0.05).The recovery times of consciousness,original reflex,muscle tone,autonomous breastfeeding and hospitalization in the observation group were significantly shorter than those in the control group(P<0.05).The total incidence of adverse reactions in the observation group was 4.88%,which was significantly lower than 19.52%in the control group(P<0.05).Conclusion Monosialotetrahexosylganglioside sodium injection combined with caffeine citrate can promote the repair of neurological function after brain injury in children,shorten the recovery time and promote the recovery,and the clinical therapeutic effect is good,which has certain clinical application value.