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目的:探讨外源性磷酸肌酸对重度窒息新生儿血清S-100B蛋白和特异性神经元烯醇化酶含量(NSE)的影响。方法:重度窒息的新生儿40例,随机分为两组,常规治疗组21例,给予一般治疗(氧疗、支持、对症)和胞二磷胆碱治疗。磷酸肌酸治疗组19例,在常规治疗基础上,生后12h内给予磷酸肌酸治疗1g/d),另外同期住院的新生儿湿肺和黄疸患儿14例为正常对照组。均与生后48h和生后10天取血检测血清S-100B蛋白和NSE含量。并于生后第14天进行新生儿行为神经测定(NBNA评分)。结果:磷酸肌酸治疗组和常规治疗组患儿生后48h血清S-100B蛋白和NSE含量无显著差异(※P>0.05,※P>0.05),与正常对照组比较差异具有显著性(△P<0.05,△P<0.05),生后10天血清S-100B和NSE含量在常规治疗组患儿和磷酸肌酸组相比具有显著差异,磷酸肌酸治疗组两者明显下降(※P<0.05,※P<0.05)。生后三周的行为神经评估(NBNA评分)<35分者所占百分比磷酸肌酸治疗组27%与常规治疗组组53%比较,差异均具有显著性意义(x2=6.112,※P<0.05)。结论:磷酸肌酸用于治疗新生儿缺氧缺血性脑病能够改善脑的能量代谢,降低脑损伤的程度,改善神经行为,降低致残率。
Objective: To investigate the effects of exogenous creatine phosphate on serum S-100B protein and specific neuron enolase (NSE) levels in neonates with severe asphyxia. Methods: Forty infants with severe asphyxia were randomly divided into two groups. The conventional treatment group (n = 21) received general treatment (oxygen therapy, supportive, symptomatic treatment) and citicoline treatment. In the group treated with creatine phosphate, 19 cases were treated with creatine phosphate 1 g / d within 12 hours after birth on the basis of routine treatment. In addition, 14 cases of neonates with wet lung and jaundice were hospitalized in the same period as the normal control group. Blood samples were taken for serum S-100B protein and NSE content 48 h after birth and 10 days after birth. Neonatal behavioral nerve assessment (NBNA score) was performed on the 14th day after birth. Results: There was no significant difference in serum S-100B protein and NSE content between the creatine phosphate group and the routine treatment group at 48 hours after birth (P> 0.05, P> 0.05), and the difference was significant compared with the normal control group P <0.05, P <0.05). Serum levels of S-100B and NSE tended to be significantly lower than those in the conventional treatment group and phosphocreatine group <0.05, ※ P <0.05). Behavioral neurological assessment (NBNA score) <35 in three weeks after birth Percentage of patients in the control group Phosphocreatine treatment group 27% compared with 53% of the conventional treatment group, the difference was significant (x2 = 6.112, P <0.05 ). CONCLUSION: Phosphocreatine therapy for neonatal hypoxic-ischemic encephalopathy can improve brain energy metabolism, reduce the degree of brain damage, improve neurological behavior and reduce morbidity.