目的 研究胞二磷膽堿聯(lián)合奧拉西坦治療新生兒缺氧缺血性腦病的臨床療效。方法 選取2016年9月—2018年10月海安市人民醫(yī)院收治的缺血缺氧性腦病患兒100例納入此次研究范圍，采用數(shù)字表法將所有患兒隨機分為對照組和治療組，每組各50例。對照組靜脈滴注奧拉西坦注射液，1 g加入到5%葡萄糖注射液50 mL中，1次/d。治療組在對照組治療的基礎(chǔ)上靜脈滴注胞二磷膽堿注射液，1 mL加入到10%葡萄糖注射液30 mL中，1次/d。兩組患兒均持續(xù)治療2周。觀察兩組的臨床療效，比較兩組的血清學指標、新生兒神經(jīng)行為（NABA）評分、運動發(fā)育指數(shù)（PDI）評分和智力發(fā)育指數(shù)（MDI）評分。結(jié)果 治療后，對照組和治療組的總有效率分別為72.0%、90.0%，兩組比較差異有統(tǒng)計學意義（P<0.05）。治療后，兩組患兒血清基質(zhì)金屬蛋白酶-9（MMP-9）和Tau蛋白（Tau）水平均明顯降低，脂聯(lián)素（APN）和胰島素樣生長因子-1（IGF-1）水平均明顯增高，同組治療前后比較差異有統(tǒng)計學意義（P<0.05）；且治療組血清學指標明顯優(yōu)于對照組，兩組比較差異有統(tǒng)計學意義（P<0.05）。治療后，兩組患兒NBNA評分顯著提高，同組治療前后比較差異有統(tǒng)計學意義（P<0.05）；且治療組NBNA評分明顯高于對照組，兩組比較差異有統(tǒng)計學意義（P<0.05）。治療后90 d進行隨訪，兩組患兒PDI評分和MDI評分顯著提高，同組治療前后比較差異有統(tǒng)計學意義（P<0.05）；且治療組PDI評分和MDI評分明顯高于對照組，兩組比較差異有統(tǒng)計學意義（P<0.05）。結(jié)論 胞二磷膽堿注射液聯(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，可改善血清MMP-9、Tau、APN和IGF-1水平，提升患兒神經(jīng)行為和智力發(fā)育情況，具有一定的臨床推廣應用價值。

Objective To study the clinical effect of Citicoline Injection combined with Oxiracetam Injection in treatment of neonatal hypoxic ischemic encephalopathy. Methods Newborns (100 cases) with hypoxic ischemic encephalopathy in Haian People's Hospital from September 2016 to October 2018 were randomly divided into control and treatment groups, and each group had 50 cases. Newborns in the control group were iv administered with Oxiracetam Injection, 1 g added into 5% glucose solution 50 mL, once daily. Newborns in the treatment group were iv administered with Citicoline Injection on the basis of the control group, 1 mL added 10% glucose solution 30 mL, once daily. Newborns in two groups were treated for 2 weeks. After treatment, the clinical efficacies were evaluated, and serological indexes, NBNA scores, PDI scores, and MDI scores in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 72.0% and 90.0%, respectively, and there was difference between two groups (P<0.05). After treatment, the levels of MMP-9 and Tau in two groups were significantly decreased, but the levels of APN and IGF-1 in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the serological indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, NBNA scores in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the NBNA score in the treatment group was significantly higher than that in the control group, with significant difference between two groups (P<0.05). After treatment, PDI scores and MDI scores in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). Conclusion Citicoline Injection combined with Oxiracetam Injection has clinical curative effect in treatment of neonatal hypoxic ischemic encephalopathy, can the levels of serum MMP-9, Tau, APN and IGF-1, and enhance the neurobehavioral and intellectual development, which has a certain clinical application value.