目的 探討醒腦靜注射液聯(lián)合奧拉西坦注射液治療新生兒缺氧缺血性腦病的臨床療效。方法 選取2019年6月—2021年7月林州市婦幼保健院收治70例新生兒缺氧缺血性腦病患兒，根據(jù)隨機數(shù)字表法將70例患兒分為對照組和治療組，每組各35例。對照組靜脈滴注奧拉西坦注射液，1.0 g加入50 mL葡萄糖注射液稀釋后緩慢滴注，1次/d。治療組在對照組基礎上靜脈滴注醒腦靜注射液，劑量0.5 mL/kg，1次/d。兩組患兒連續(xù)治療2周。觀察兩組的臨床療效，比較兩組患兒神經(jīng)行為功能、主要癥狀的恢復時間、血清高遷移率族蛋白B1（HMGB1）、胰島素樣生長因子（IGF-1）、缺氧誘導因子-1α（HIF-1α）水平。結果 治療后，治療組患兒的總有效率為97.14%，對照組的總有效率為82.86%，組間差異有統(tǒng)計學意義（P＜0.05）。治療后，兩組的新生兒神經(jīng)行為測定（NBNA）評分明顯比治療前高（P＜0.05），且治療組的NBNA評分比對照組高（P＜0.05）。治療后，治療組患兒肌張力、意識、反射恢復時間均明顯短于對照組（P＜0.05）。治療后，兩組的血清HMGB1、HIF-1α水平顯著減少，IGF-1水平顯著增多（P＜0.05）；治療組的血清HMGB1、HIF-1α水平比對照組低，IGF-1水平比對照組高（P＜0.05）。結論 醒腦靜注射液聯(lián)合奧拉西坦注射液治療新生兒缺氧缺血性腦病的療效確切，能顯著改善臨床癥狀和神經(jīng)行為功能，調節(jié)HMGB1、IGF-1、HIF-1α的分泌，藥物安全性良好。

Objective To investigate the clinical efficacy of Xingnaojing Injection combined with Oxiracetam Injection in treatment of neonatal hypoxic-ischemic encephalopathy. Methods Infants (70 cases) with neonatal hypoxic-ischemic encephalopathy in Linzhou Maternal and Child Health Hospital from June 2019 to July 2021 were randomly divided into control and treatment groups, and each group had 35 cases. Infants in the control group were iv administered with Oxiracetam Injection, 1.0 g added into glucose Injection 50 mL, once daily. Infants in the treatment group were iv administered with Xingnaojing Injection on the basis of the control group, 0.5 mL/kg, once daily. Infants in two groups were treated for 2 weeks. After treatment, the clinical efficacies were evaluated, and neurobehavioral function, the recovery time of main symptoms and signs, and the serum level of HMGB1, IGF-1, and HIF-1α in two groups were compared. Results After treatment, the total effective rate was 97.14% in the treatment group and 82.86% in the control group, and there was significant difference between the groups (P < 0.05). After treatment, the NBNA score of two groups was significantly higher than that before treatment (P < 0.05), and the NBNA score of the treatment group was higher than that of the control group (P < 0.05). After treatment, the recovery time of muscle tension, consciousness, and reflex in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, the levels of HMGB1 and HIF-1 α in two groups were significantly decreased, but the level of IGF-1 in two groups were significantly increased (P < 0.05). The levels of HMGB1 and HIF-1α in the treatment group were lower than those in the control group, but the level of IGF-1 in the treatment group was higher than those in the control group (P < 0.05). Conclusion Xingnaojing Injection combined with Oxiracetam Injection is effective in the treatment of neonatal hypoxic-ischemic encephalopathy, can significantly improve clinical symptoms and neurobehavioral function, and regulate the secretion of HMGB1, IGF-1 and HIF-1α, with good safety.

R971

河南省醫(yī)學科技攻關計劃項目(201702193)