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目的探讨神经节苷脂(GM1)治疗新生儿缺氧缺血性脑病(HIE)的临床疗效及对血清神经元特异性烯醇化酶(neuron-specific-enolase NSE)的影响。方法临床诊断为HIE的新生儿103例,随机分为GM1治疗组(55例)和对照组(48例)。两组均采用常规治疗,GM1治疗组在常规治疗的基础上给予GM1静脉滴注治疗,1次/d,20mg/次,14天为一疗程。分别检测两组治疗前(生后3天)和治疗后(生后14天)血清NSE的含量;以临床症状消失时间比较近期疗效;随访至1岁,以Gesell发育诊断量表进行智能发育最终评估,以精神运动发良商(DQ)比较远期疗效。结果治疗后GM1治疗组血清NSE明显低于对照组(P<0.01)。GM1治疗组近期和远期疗效均优于对照组,治疗总有效率和1岁时DQ值均高于对照组(P<0.05)。结论 GM1对HIE新生儿具有脑保护作用,能减轻临床症状,改善预后。
Objective To investigate the clinical efficacy of ganglioside (GM1) in the treatment of neonatal hypoxic-ischemic encephalopathy (HIE) and its effect on serum neuron-specific-enolase (NSE). Methods A total of 103 newborns diagnosed as HIE were randomly divided into GM1 treatment group (55 cases) and control group (48 cases). The two groups were treated by conventional therapy. GM1 treatment group was given GM1 intravenous drip treatment on the basis of routine treatment, once / d, 20mg / time, 14 days for a course of treatment. The levels of NSE in serum before treatment (3 days after birth) and after treatment (14 days after birth) were detected respectively. The clinical efficacy of NSE was compared with the disappearance time of the clinical symptoms. The follow-up to 1 year old was performed with the Gesell developmental diagnostic scale Assessment to psychomotor development (DQ) more long-term efficacy. Results After treatment, the serum NSE of GM1 group was significantly lower than that of the control group (P <0.01). The short-term and long-term effects of GM1 in treatment group were better than those in control group. The total effective rate and DQ value at 1 year old were higher than those in control group (P <0.05). Conclusion GM1 has a protective effect on neonates with HIE, which can reduce clinical symptoms and improve prognosis.