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目的研究神经节苷脂GM1治疗新生儿缺氧缺血性脑病患儿血浆神经元特异性烯醇酶(NSE)的动态变化及其临床意义。方法将新生儿科住院的90例新生儿缺氧缺血性脑病患儿分为轻度组18例、常规治疗组33例、GM1组39例。GM1组在常规治疗基础上加用神经节苷脂,20 mg/次,静脉滴注1次/d,10～14 d为1个疗程。治疗前后分别检测血浆NSE,同时以25例正常新生儿组作对照。治疗前及治疗1个疗程后各进行脑CT检查1次;治疗前、治疗1个疗程后和生后28 d各进行NBNA测定1次;生后1个月起至生后12个月每月DQ检测1次。结果GM1组和常规治疗组治疗后血浆神经元特异性烯醇酶有显著下降(P<0.05),GM1组比常规治疗组下降更显著。轻度组血浆神经元特异性烯醇酶改变差异无统计学意义(P>0.05)。GM1组在CT好转率、NBNA评分及DQ评分意识障碍恢复方面明显好于常规治疗组(P<0.05),差异有统计学意义。结论神经节苷脂治疗新生儿缺氧缺血性脑病具有十分重要价值。
Objective To investigate the dynamic changes of plasma neuron specific enolase (NSE) in neonates with hypoxic-ischemic encephalopathy and its clinical significance. Methods 90 neonates with neonatal hypoxic-ischemic encephalopathy hospitalized in neonates were divided into mild treatment group (n = 18), conventional treatment group (n = 33) and GM1 group (n = 39). GM1 group in the conventional treatment based on the addition of gangliosides, 20 mg / time, intravenous infusion 1 / d, 10 ~ 14 d for a course of treatment. Before and after treatment were detected plasma NSE, while 25 normal neonatal control group. Before treatment and after treatment of a course of treatment of each CT scan 1; before treatment, after treatment of 1 course of treatment and after 28 days of each NBNA determination of 1; 1 month after birth to 12 months after birth, each month DQ test once. Results After treatment, the levels of plasma neuron-specific enolase decreased significantly in GM1 group and conventional treatment group (P <0.05), and GM1 group decreased more significantly than the conventional treatment group. There was no significant difference in mild neuron-specific enolase (P> 0.05). The GM1 group was significantly better than the conventional treatment group in CT improvement rate, NBNA score and DQ score disturbance of consciousness (P <0.05), the difference was statistically significant. Conclusion Gangliosides are very important for the treatment of neonatal hypoxic-ischemic encephalopathy.