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目的研究大小剂量地塞米松对小儿缺血缺氧性脑病的疗效。方法将110例H IE小儿分为地塞米松大剂量治疗组55例,小剂量治疗组55例,分别在出生后24h内应用地塞米松2mg(kg·d)和1mg(kg·d)分两次静脉滴注,连用3d后停药。对照组80例。比较大小剂量治疗组治疗前后血浆过氧化脂质(LPO)、一氧化氮(NO)、血皮质醇(PTC)和促肾上腺皮质激素(ACTH)水平,及小儿神经行为评分(20项NBNA评分)的变化并与对照组比较。结果大小剂量治疗组治疗前LPO、PTC、NO水平均高于对照组(P<0.05,P<0.01),ACTH基本正常。大剂量治疗组LPO、PTC、NO均有明显下降,而小剂量组下降不明显。治疗后20项NBNA评分大剂量组明显高于小剂量组(P<0.05,P<0.01)。结论早期短时大剂量地塞米松治疗H IE疗效肯定。
Objective To study the effect of large dose dexamethasone on children with hypoxic ischemic encephalopathy. Methods One hundred and ten children with H IE were divided into two groups: 55 cases in dexamethasone high dose group and 55 cases in low dose group. Dexamethasone 2 mg (kg · d) and 1 mg (kg · d) Two intravenous drip, even after the withdrawal with 3d. Control group of 80 cases. The levels of plasma LPO, NO, ACTH and ACTH before and after treatment were compared between the two groups, and the neurobehavioral score (20 NBNA scores) Changes and compared with the control group. Results The levels of LPO, PTC and NO before and after treatment in the treatment group were higher than those in the control group (P <0.05, P <0.01), and the ACTH was normal. High-dose treatment group LPO, PTC, NO were significantly decreased, while the small dose group did not decline significantly. After treatment, the 20 NBNA scores in the high-dose group were significantly higher than those in the low-dose group (P <0.05, P <0.01). Conclusion Early short-term high-dose dexamethasone treatment of H IE positive effect.