磷酸肌酸钠联合神经节苷脂治疗窒息新生儿脑损伤的临床疗效

Clinical Efficacy of Sodium Creatine Phosphate Combined with Ganglioside in the Treatment of Brain Injury in Neonates with Asphyxia

目的:探讨磷酸肌酸钠(CP)联合神经节苷脂治疗窒息新生儿脑损伤的临床疗效。方法:选取2012年7月—2016年8月于我院出生且伴有窒息和脑损伤的新生儿154例,按随机数字表法分为观察组与对照组,各77例。观察组采取磷酸肌酸钠(1 g,bid,ivgtt)联合神经节苷脂(20 mg,ivgtt,qd)治疗,对照组给予单一磷酸肌酸钠治疗。比较两组疗效及血清钙、一氧化氮(NO)、神经元特异性烯醇化酶(NSE)、S100B水平。结果:治疗前,两组血清钙、NO、NSE、S100B、肌酸激酶同工酶(CK-MB)、肌钙蛋白(cTnl)水平及新生儿神经行为测定(NBNA)评分比较,差异无统计学意义(P> 0.05);治疗后,两组血清钙水平及NBNA评分较治疗前升高,NO、NSE、S100B、CK-MB及cTnl水平较治疗前下降,且观察组指标变化均优于对照组,差异有统计学意义(P <0.05);观察组治疗总有效率高于对照组,差异有统计学意义(P <0.05)。结论:磷酸肌酸钠联合神经节苷脂治疗窒息新生儿脑损伤的疗效显著,能升高患儿血清钙水平,降低NO、NSE、S100B水平,在修复受损组织的同时减少恶性病变的发生率,改善预后。

Objective:To investigate the clinical efficacy of sodium creatine phosphate(CP)combined with ganglioside in the treatment of brain injury in neonates with asphyxia.Methods:154 neonates with asphyxia and brain injury born in our hospital from July 2012 to August 2016 were selected and randomly divided into an observation group and a control group,77 cases each.The neonates in the observation group were treated with sodium creatine phosphate(1 g,bid,ivgtt)combined with ganglioside(20 mg,ivgtt,qd),and the neonates in the control group were treated with single sodium creatine phosphate.The efficacy and serum calcium,nitric oxide(NO),neuron-speci?c enolase(NSE)and S100 B levels were compared between the two groups.Results:Before treatment,there were no statistically significant differences in serum calcium,NO,NSE,S100 B,creatine kinase isoenzyme(CK-MB)and troponin(cTnl)levels and neonatal neurobehavioral assay(NBNA)scores between the two groups(P>0.05).The serum level of calcium and NBNA scores in the two groups after treatment were higher than those before treatment,and the levels of NO,NSE,S100 B,CK-MB and cTnl were lower than those before treatment,and the changes in the indexes in the observation group were better than those in the control group,with statistically signi?cant differences(P<0.05).The total effective rate in the observation group was higher than that in the control group,and the difference was statistically signi?cant(P<0.05).Conclusion:Sodium creatine phosphate combined with ganglioside is significantly effective in the treatment of brain injury in neonates with asphyxia,which can increase serum calcium level,decrease NO,NSE and S100 B levels,reduce the incidence of malignant lesions while repairing damaged tissues,and improve prognosis.