目的 探討鹽酸甲氯芬酯聯合單唾液酸四己糖神經節(jié)苷脂治療新生兒缺氧缺血性腦病的療效觀察。方法 選取2019年5月-2021年5月在南陽市中心醫(yī)院治療的98例新生兒缺氧缺血性腦病患兒,隨機分為對照組(49例)和治療組(49例)。對照組靜脈滴注單唾液酸四己糖神經節(jié)苷脂注射液,20 mg/次,1次/d。治療組在對照組的基礎上靜脈滴注注射用鹽酸甲氯芬酯,60 mg/次,2次/d。兩組患兒連續(xù)用藥7 d。觀察兩組患者臨床療效,比較治療前后兩組患兒臨床癥狀改善時間,血清白細胞介素-8(IL-8)、腫瘤壞死因子-α(TNF-α)、神經特異性烯醇化酶(NSE)、白細胞介素-6(IL-6)水平,及神經行為測定(NBNA)評分。結果 治療后,治療組患兒總有效率明顯高于對照組(97.96% vs 81.63%,P<0.05)。治療后,治療組臨床癥狀改善時間均早于對照組(P<0.05)。治療后,兩組患兒血清IL-6、IL-8、TNF-α、NSE水平均明顯低于同組治療前(P<0.05),且治療組患兒明顯低于對照組(P<0.05)。治療后,兩組患兒NBNA評分顯著高于治療前(P<0.05),且治療組明顯高于對照組(P<0.05)。結論 單唾液酸四己糖神經節(jié)苷脂聯合鹽酸甲氯芬酯治療新生兒缺氧缺血性腦病效果明顯,能有效降低腦部炎性反應,促進腦神經功能的恢復能力。

Objective To investigate the therapeutic effect of meclofenoxate combined with monosialotetrahexosylganglioside sodium in treatment of neonatal hypoxic-ischemic encephalopathy. Methods Children (98 cases) with neonatal hypoxic-ischemic encephalopathy in Nanyang Central Hospital from May 2019 to May 2021 were randomly divided into control (49 cases) and treatment (49 cases) group. Children in the control group were iv administered with Monosialotetrahexosylganglioside Sodium Injection, 20 mg/time, once daily. Children in the treatment group were iv administered with Meclofenoxate Hydrochloride for injection on the basis of the control group, 60 mg/time, twice daily. Children in two groups were treated for 7 d. After treatment, the clinical evaluation was evaluated, the improvement of clinical symptoms, the levels of serum IL-6, IL-8, TNF-α, and NSE, and NBNA scores in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was significantly higher than that of the control group (97.96% vs 81.63%, P < 0.05). After treatment, the improvement time of clinical symptoms in the treatment group was significantly earlier than that in the control group (P < 0.05). After treatment, the serum levels of IL-6, IL-8, TNF-α, and NSE in two groups were significantly lower than those before treatment (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the NBNA score in two groups was significantly higher than that before treatment (P < 0.05), and which in the treatment group was significantly higher than that of the control group (P < 0.05). Conclusion The combination of monosialotetrahexose ganglioside and meclofenoxate hydrochloride is effective in the treatment of neonatal hypoxic-ischemic encephalopathy, which can effectively reduce the inflammatory response in the brain and promote the recovery of brain nerve function.

R971

河南醫(yī)學科技攻關項目（LHGJ20191453）