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目的探讨亚低温联合促红细胞生成素(EPO)治疗中重度新生儿缺氧缺血性脑病(HIE)的疗效。方法出生6h中重度HIE新生儿55例分为四组。B组(15例)予亚低温治疗72h;C组(13例)予EPO 300IU/kg,隔日1次,治疗12d;A组(13例)采用B、C组联合治疗方法;D组14例为对照组。治疗前和治疗后24、72h和7d,ELISA法检测新生儿血清神经元特异性烯醇化酶(NSE)和S100B蛋白水平;出生7d和28d行新生儿行为神经测定(NBNA)评分。结果治疗后24、72h和7d,A、B和C组血清NSE和S100B水平均低于D组(P<0.05),A组NSE和S100B水平低于B、C组(P<0.05)。出生7、28d,A、B和C组NBNA评分均高于D组(P<0.05),出生28d,A组NBNA评分高于B、C组(P<0.05)。结论亚低温联合EPO治疗能有效改善HIE新生儿神经系统预后。
Objective To investigate the efficacy of mild hypothermia combined with erythropoietin (EPO) in the treatment of moderate and severe neonatal hypoxic-ischemic encephalopathy (HIE). Methods Sixty-six neonates with moderate to severe HIE were divided into four groups. Group B (n = 15) received hypothermia for 72 hours; Group C (n = 13) received EPI 300 IU / kg every other day for 12 days; Group A (n = 13) received combination therapy of group B and For the control group. Serum neuron-specific enolase (NSE) and S100B protein levels were measured by ELISA before and 24,72 and 7 days after treatment. Neonatal behavioral neurological assessment (NBNA) was performed on the 7th and 28th day after birth. Results Serum levels of NSE and S100B in groups A, B and C were significantly lower than those in group D at 24, 72 and 7 days after treatment (P <0.05). The levels of NSE and S100B in group A were lower than those in groups B and C (P <0.05). At 7 and 28 days of birth, the NBNA scores of A, B and C groups were significantly higher than those of D group (P <0.05). On the 28th day of birth, the NBNA score of A group was higher than that of B and C groups (P <0.05). Conclusion Mild hypothermia combined with EPO treatment can effectively improve the prognosis of neonatal neural system HIE.