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目的:探讨复方丹参注射液联合纳洛酮对新生儿缺氧缺血性脑病(HIE)氧化应激和炎症的影响。方法:102例HIE患儿随机分为两组,对照组给予抗惊厥、吸氧、营养支持、降颅压及维持酸碱平衡等常规治疗,治疗组在常规治疗的基础上,纳洛酮0.05 mg.kg-1,静脉注射,随后0.04 mg.kg-1.h-1连续6 h泵入,共3～5 d;复方丹参注射液0.5～1.0 mL.kg-1,静滴,1次/d,连续10 d。比较治疗前、治疗第7天血清中超氧化物歧化酶(SOD)、丙二醛(MDA)、一氧化氮(NO)、谷胱甘肽过氧化物酶(GSH-Px)、白细胞介素(IL)-6、超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子(TNF)-α水平,并对患儿进行NBNA评分。结果:两组治疗第7天,两组MDA,NO,IL-6,hs-CRP,TNF-α水平下降显著,SOD,GSH-Px上升显著(P<0.05或P<0.01);与对照组比较,治疗组的各指标变化幅度明显大于对照组(P<0.05)。新生儿神经行为评分(NBNA)比较,两组患儿治疗后14,28 d,治疗组明显高于对照组(P<0.05)。结论:复方丹参注射液联合纳洛酮能较好的抑制HIE患儿炎症反应,减轻缺氧缺血的氧化应激反应,改善机体神经功能。
Objective: To investigate the effects of compound salvia miltiorrhiza injection combined with naloxone on oxidative stress and inflammation in neonatal hypoxic-ischemic encephalopathy (HIE). Methods: A total of 102 HIE children were randomly divided into two groups. The control group was given anticonvulsant, oxygen inhalation, nutritional support, intracranial pressure and maintenance of acid-base balance. The treatment group was treated with naloxone 0.05 mg.kg-1, intravenous injection, followed by 0.04 mg.kg-1.h-1 for 6 h continuous pumping, a total of 3 ~ 5 d; compound Danshen injection 0.5 ~ 1.0 mL.kg-1, intravenous infusion, / d for 10 days. The levels of serum superoxide dismutase (SOD), malondialdehyde (MDA), nitric oxide (NO), glutathione peroxidase (GSH-Px), interleukin (IL-6), hs-CRP and TNF-α, and NBNA scores were evaluated. Results: On the 7th day after treatment, the levels of MDA, NO, IL-6, hs-CRP and TNF-α in the two groups decreased significantly and the levels of SOD and GSH-Px increased significantly (P < Compared with the control group, the changes in each index of the treatment group were significantly (P <0.05). Neonatal neurobehavioral score (NBNA) comparison, two groups of children 14 and 28 d after treatment, the treatment group was significantly higher than the control group (P <0.05). Conclusion: Compound Danshen injection combined with naloxone can inhibit the inflammatory response of HIE infants better, reduce the oxidative stress response of hypoxia-ischemia and improve the neurological function.