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脑活素对高危早产儿神经发育结局的影响:一项随机对照试验。

Effect of cerebrolysin on neurodevelopmental outcome of high risk preterm infants: A randomized controlled trial.

机构信息

Mansoura University Children's Hospital, Mansoura, Egypt.

Departemnet of Pediatrics, Faculty of Medicine, University of Mansoura, Mansoura, Egypt.

出版信息

J Neonatal Perinatal Med. 2022;15(1):37-45. doi: 10.3233/NPM-200659.

Abstract

BACKGROUND

A significant proportion of preterm infants experience developmental delay despite receiving a post discharge early interventional care. Cerebrolysin is a peptide mixture which acts similar to endogenous neurotrophic factors through promoting neurogenesis and enhancing neuronal plasticity.

OBJECTIVE

To compare the effect of Cerebrolysin plus routine intervention program versus routine intervention program alone on the outcome of preterm infants at high risk for neurodevelopmental delay.

METHODS

In a randomized controlled trial, high-risk preterm infants < 32 weeks' gestation who have abnormal neurological assessment at two months corrected post-natal age were randomized at 6 months corrected post natal age to receive either early intervention program or early intervention program plus Cerebrolysin injection of 0.1 mL/kg body weight every week for 3 months as an adjuvant therapy. The primary outcome was the rate of failure of the gross motor assessment at 12 months of corrected age and secondary outcomes included fine motor, language, and personal social development at 12 months corrected post-natal age as assessed by Denver Developmental Screening Test II.

RESULTS

Cerebrolysin group had a significant lower number of infants diagnosed with failed gross motor development compared to infants in the routine intervention group [10 (33%) versus 21 (70%), p = 0.009]. Cerebrolysin group had a significant lower number of infants diagnosed with failed fine motor, language and personal social development compared to infants in the routine intervention group.

CONCLUSION

Cerebrolysin, as an adjuvant therapy to routine early interventional care, may improve gross motor development of high-risk preterm infants at 12 months corrected post-natal age.

摘要

背景

尽管早产儿接受了出院后的早期干预性护理,但仍有相当一部分早产儿存在发育迟缓的情况。脑活素是一种肽混合物,通过促进神经发生和增强神经元可塑性,起到类似于内源性神经营养因子的作用。

目的

比较脑活素联合常规干预方案与单纯常规干预方案对有神经发育迟缓高危风险的早产儿结局的影响。

方法

在一项随机对照试验中,将胎龄<32 周且在两个月纠正胎龄后神经评估异常的高危早产儿,在 6 个月纠正胎龄后随机分为早期干预组或早期干预组加脑活素(0.1ml/kg 体重)每周 1 次,连续 3 个月作为辅助治疗。主要结局是在纠正 12 个月龄时运动功能评估失败的发生率,次要结局包括在纠正 12 个月龄时通过丹佛发育筛查测试 II 评估的精细运动、语言和个人社会发展的发生率。

结果

脑活素组被诊断为运动功能发育不良的婴儿数量明显少于常规干预组[10(33%)比 21(70%),p=0.009]。脑活素组被诊断为精细运动、语言和个人社会发展不良的婴儿数量明显少于常规干预组。

结论

脑活素作为常规早期干预性护理的辅助治疗,可能改善高危早产儿在纠正 12 个月龄时的运动功能发育。

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