神经生长因子早期治疗中重度新生儿缺氧缺血性脑病的疗效(1)
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【摘要】 目的 观察神经生长因子(NGF)早期治疗新生儿中重度缺氧缺血性脑病(HIE)的疗效。方法 中重度HIE新生儿86例随机分为2组:对照组42例，NGF干预组44例，2组患儿均予常规治疗。干预组在常规治疗的基础上早期(生后6 h内)应用NGF静脉滴注治疗，1次/d,10～14 d为1个疗程。治疗前、治疗1个疗程和28 d检查头颅CT、行新生儿行为神经评分(NBNA),3个月和6个月采用首都儿科研究所儿心量表(CDCC)评定智力(MDI)/运动(PDI)发育指数。结果 NGF干预组头颅CT影像学脑结构的恢复及NBNA评分均明显优于对照组(P<0.05), MDI、PDI等各项指标与对照组比较有明显改善(P<0.01)。结论 早期应用NGF治疗中重度新生儿HIE疗效明显。
【关键词】 缺氧缺血； 脑；神经生长因子；婴儿，新生
Curative effects of nerve growth factor on neonates with moderate and sever hypoxic-ischemic encephalopathy
CUI Jian-po,HAO Yan-feng.
Kaifeng Childrens Hospital,Kaifeng 475000,China
【Abstract】 Objective To observe the curative efects of nevergrowthfactor(NGF)on neonates with moderate and severe hypoxic-ischemic encephalopathy(HIE). Methods Eighty-six neonates with HIE were randomly divided into NGF treatment group andcontrol group.The control group(42 cases)were received routine treatment(including cerebrolysin and citicoline)；the treatment group(44 cages)were given NGF on the basis of routine treatment as early as possible(within 6 hours after birth).Brain CT，neonatal behavioral neuro-logical assessment(NBNA)and children’s development center of China(CDCC)at 3 and 6 months after birth were proformed in both groups.Results Brain CT，NBNA and CDCC markers in treatment group were better than those in control group(P<0.05).There were great diferences between two groups(P<0.01).Conclusion Using NGF on the basis of the routine treatment as early as possible after resuscitationcan reduce markely the severity of asphyxia induced brain damage in neonates.It is very effective using NGF in treating HIE in neonates.
【Key words】 Hypoxic-ischemic; Brain; Nerve growth factor；Infant; Newborn
缺氧缺血性脑病(HIE)是儿科常见病，是导致新生儿死亡和伤残的重要原因之一，目前尚无特效治疗。神经生长因子(nerve growth factorNGF)对神经细胞的发育、成熟、分化及存活起着重要的作用，可促进脑损伤的恢复，从而达到治疗目的。本科自2006年6月开始用NGF治疗新生儿HIE，并取得较满意疗效。
1 资料与方法
1.1 一般资料 本科2006年6月至2007年12月收治中、重度HIE患儿86例,均符合HIE诊断及分度标准。随机分为对照组42例和NGF干预组44例。对照组中度HIE 29例，重度HIE 13例；男27例，女15例；日龄(4.0±0.5)h；胎龄(38±0.7)周；出生体重(3.4±0.5)kg；5 min Apgar 评分2、3分9例，4～7分33例。NGF干预组中度HIE 29例，重度HIE 15例；男28例，女16例；日龄(4.0±0.6)h；胎龄(38±0.4)周；出生体重(3.5±0.4)kg；5 min Apagar 评分1～3分11例，4～7分33例。2组胎龄、性别、日龄、体重、5 min Apagar评分比较差异无统计学意义(P>0.05)。
1.2 治疗方法 对照组予常规治疗，包括三支持、三对症 ......
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