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不同轻度脑低温治疗时间对中重度缺氧缺血性脑病新生儿氧化因子和神经保护作用的疗效。

Efficacy of different treatment times of mild cerebral hypothermia on oxidative factors and neuroprotective effects in neonatal patients with moderate/severe hypoxic-ischemic encephalopathy.

机构信息

Department of Neonatology, The First People's Hospital of Lianyungang, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, Jiangsu, China.

出版信息

J Int Med Res. 2020 Sep;48(9):300060520943770. doi: 10.1177/0300060520943770.

Abstract

OBJECTIVE

To investigate the efficacy of different treatment times of mild cerebral hypothermia for treating moderate/severe hypoxic-ischemic encephalopathy (HIE) in neonatal patients and its effects on oxidative factors.

METHODS

This prospective, randomized, controlled study included 92 neonatal patients with moderate/severe HIE and 30 controls. The patients with HIE received routine treatment, 48 hours of hypothermia, or 72 hours of hypothermia.

RESULTS

Superoxide dismutase (SOD) values were significantly lower and malondialdehyde (MDA) and neuron-specific enolase (NSE) values were higher in patients with HIE than in controls before the study. After 24, 48, and 72 hours of treatment, SOD values in all patients with HIE gradually increased and MDA and NSE values gradually decreased. At 3, 7, and 10 days, the Neonatal Behavioral Neurological Assessment scores were highest in the mild hypothermia for 72 hours group than in the other groups. The Mental and Psychomotor Development Indices scores of the Bayley Scales were significantly higher in the mild hypothermia for 72 hours group than in the other groups.

CONCLUSION

Hypothermia treatment of 72 hours is better than 48 hours for improving oxidative conditions, reducing NSE values, and improving neurological behavior and development for neonates with moderate/severe HIE.

摘要

目的

探讨不同亚低温治疗时间治疗中重度新生儿缺氧缺血性脑病(HIE)的疗效及其对氧化因素的影响。

方法

本前瞻性、随机、对照研究纳入 92 例中重度 HIE 新生儿患者和 30 例对照患者。HIE 患者接受常规治疗、48 小时亚低温治疗或 72 小时亚低温治疗。

结果

与对照组相比,HIE 患者在研究前超氧化物歧化酶(SOD)值明显降低,丙二醛(MDA)和神经元特异性烯醇化酶(NSE)值升高。所有 HIE 患者在治疗 24、48 和 72 小时后,SOD 值逐渐升高,MDA 和 NSE 值逐渐降低。在 3、7 和 10 天时,72 小时轻度亚低温组的新生儿行为神经评估评分最高。72 小时轻度亚低温组的贝利婴幼儿发展量表的精神运动发育指数评分明显高于其他组。

结论

与 48 小时相比,72 小时亚低温治疗可更好地改善氧化状态、降低 NSE 值,改善中重度 HIE 新生儿的神经行为和发育。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/757a/7503019/b77f3cfb1e30/10.1177_0300060520943770-fig1.jpg

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