促红细胞生成素联合亚低温治疗重度HIE的效果及1年发育的影响

Effects of erythropoietin combined with mild hypothermia in the treatment of severe HIE and the effect on 1-year development

目的 :探讨促红细胞生成素(EPO)联合亚低温治疗重度新生儿缺氧缺血性脑病(HIE)的临床效果及对患儿1年发育的影响。方法 :将82例HIE患儿随机分为对照组与观察组各41例。对照组采用亚低温治疗,观察组在此基础上加用EPO治疗,比较两组患儿治疗前后血神经元特异性烯醇化酶(NSE)、S100B蛋白(S-100B)、神经行为能力评分(NBNA)、神经学评分、发育评分的变化。结果 :(1)治疗24h、72h、1周,两组NSE、S-100B、神经学评分均降低,观察组各时间点降低幅度高于对照组。(2)治疗1、2、4周,两组NBNA评分均上升,观察组上升幅度高于对照组。(3)观察组3月龄、6月龄、12月龄患儿MDI、PDI评分均高于对照组,与同组3月龄比较,两组6月龄、12月龄MDI、PDI评分均上升。结论 :采用EPO联合亚低温治疗重度HIE患儿,神经保护作用显著,且可改善患儿神经功能,促进其发育。

Objective To investigate the clinical effect of erythropoietin (EPO) combined with mild hypothermia in the treatment of severe neonatal hypoxic ischemic encephalopathy (HIE) and the effect on 1-year development. Methods Eighty-two children with HIE were randomly divided into the control group and the observation group, 41 cases in each group. The control group was treated with mild hypothermia, and the observation group was additionally treated with EPO. The changes of blood neuron specific alcohol (NSE), S100B protein (S-100B), neonatal behavioral neurological assessment (NBNA) scores, neurological scores and developmental scores before and after treatment were compared between the two groups. Results Af-ter 24h, 72h and 1 week of treatment, NSE, S-100B and neurological scores were decreased, and the decreasing amplitudes in observation group were lower than those in the control group at different time points. After 1 week, 2 weeks and 4 weeks of treatment, the NBNA scores were increased, and the increasing amplitude in observation group was higher than that in control group. The MDI and PDI scores in children aged 3 months old, 6 months old and 1 year old in the observation group were higher than those in the control group. Compared with children aged 3 months old in the same group, the MDI and PDI scores in chil-dren aged 6 months old and 1 year old were higher. Conclusion The application of EPO combined with mild hypothermia in the treatment of severe HIE in children can significantly protect and improve the neurological function and promote the develop-ment of children.