神经节苷脂联合纳洛酮治疗新生儿缺氧缺血性脑病的效果及其对IL-6、hs-CRP、TNF-α水平的影响

郭锦华

【摘要】 目的：探讨神经节苷脂联合纳洛酮治疗新生儿缺氧缺血性脑病（HIE）的效果及其对IL-6、hs-CRP、TNF-α水平的影响。方法：选取2018年5月-2020年5月本院收治的90例HIE患儿为研究对象。将患儿随机分成对照组和研究组，每组45例。对照组给予纳洛酮治疗，研究组在对照组基础上给予神经节苷脂治疗。比较两组治疗效果、各项临床指标情况、NBNA评分以及炎症因子水平。结果：治疗7、14 d后，研究组NBNA评分均高于对照组，差异均有统计学意义（P<0.05）。研究组总有效率高于对照组，差异有统计学意义（P<0.05）。研究组苏醒时间、惊厥消失时间及肌张力恢复时间均短于对照组，差异均有统计学意义（P<0.05）。治疗后，研究组TNF-α、IL-6及hs-CRP水平均优于对照组，差异均有统计学意义（P<0.05）。结论：HIE患儿应用神经节苷脂联合纳洛酮治疗，可有效增强治疗效果，降低各项炎症指标水平，并促进患者脑神经功能改善，可推广使用。

【关键词】 神经节苷脂 纳洛酮 新生儿缺氧缺血性脑病 IL-6 hs-CRP TNF-α

[Abstract] Objective： To investigate the effect of Ganglioside combined with Naloxone in the treatment of neonatal hypoxic-ischemic encephalopathy （HIE） and its influence on the levels of IL-6， hs-CRP and TNF-α. Method： A total of 90 children with HIE treated in our hospital from May 2018 to May 2020 were selected as the research objects. The children were randomly divided into control group and study group， 45 cases in each group. The control group was treated with Naloxone， the study group was treated with Ganglioside on the basis of the control group. The therapeutic effect， clinical indicators， NBNA score and levels of inflammatory factors were compared between the two groups. Result： After 7 and 14 days of treatment， NBNA scores in the study group were higher than those in the control group， the differences were statistically significant （P<0.05）. The total effective rate of the study group was higher than that of the control group， the difference was statistically significant （P<0.05）. The recovery time， disappearance time of convulsion and recovery time of muscle tension in the study group were shorter than those in the control group， the differences were statistically significant （P<0.05）. After treatment， the levels of TNF-α， IL-6 and hs-CRP in study group were better than those in control group， the differences were statistically significant （P<0.05）. Conclusion： The application of Ganglioside combined with Naloxone in HIE children can effectively enhance the therapeutic effect， reduce the levels of various inflammatory indicators， and promote the improvement of patients’ brain and nerve functions， so it can be promoted and used.

[Key words] Ganglioside Naloxone Neonatal hypoxic-ischemic encephalopathy IL-6 hs-CRP TNF-α

First-author’s address： Jiamusi Maternal and Child Health Hospital， Jiamusi 154002， China

doi：10.3969/j.issn.1674-4985.2021.25.013

新生兒缺氧缺血性脑病（HIE）属于临床上比较多见的脑损伤疾病类型之一，其主要临床症状为颅内压升高、意识障碍以及脑水肿等，且部分病情进展严重的患儿极易发生残疾，甚至会危及生命[1]。当前临床上主要是通过促进患儿神经功能改善来对此类疾病实施治疗，但相关研究显示，单独使用某一种药物治疗的效果难以达到实际预期，因此联合用药治疗在临床中的应用愈发普遍[2]。神经节苷脂药物能加快机体神经重构速度，而纳洛酮属于临床上应用较多的阿片受体特异性拮抗剂药物之一，能有效提升患儿脑血流以及氧合，同时还能使惊厥以及呼吸衰竭等症状得到明显改善[3]。……