单唾液酸四己糖神经节苷脂联合胞磷胆碱治疗新生儿缺氧缺血性脑病的临床分析

doi:10.3969/j.issn.1000-8535.2018.02.008

广州医药 ›› 2018, Vol. 49 ›› Issue (2): 29-32.DOI: 10.3969/j.issn.1000-8535.2018.02.008

单唾液酸四己糖神经节苷脂联合胞磷胆碱治疗新生儿缺氧缺血性脑病的临床分析

江美玲, 张又祥, 于力

广州市第一人民医院儿科(广州 510180)

收稿日期:2017-10-09 出版日期:2018-03-20 发布日期:2021-12-01
通讯作者: 江美玲,E-mail:mljiang88@163.com

Clinical analysis of neonatal hypoxic-ischemic encephalopathy treated with ganglioside and citicoline

JIANG Meiling, ZHANG Youxiang, YU Li

Department of Pediatrics, Guangzhou First People's Hospital, Guangzhou 510180,China

Received:2017-10-09 Online:2018-03-20 Published:2021-12-01

摘要/Abstract

摘要： 目的分析神经营养类药物单唾液酸四己糖神经节苷脂(monosialotetrahexosylganglioside,GM1)与胞磷胆碱(citicoline)联合使用在新生儿缺血缺氧性脑病(neonatal hypoxic-ischemic encephalopathy,NHIE)的临床疗效并探讨其可能的作用机制。方法收集2014年1月—2017年6月在广州市第一人民医院新生儿病房住院的54例新生儿缺血缺氧性脑病患儿的临床资料,将收集到的患儿随机分为2组,对照组27例,治疗组27例。治疗组与对照组的治疗的不同在于前者予以单唾液酸四己糖神经节苷脂GM1联合胞磷胆碱治疗,而对照组仅用单唾液酸四己糖神经节苷脂GM1,无用胞磷胆碱。治疗三个疗程后,比较2组用药前后的临床表现、神经功能评分及MRI变化情况。结果治疗组中临床总有效24例(88.9%);对照组中总有效17例(63.0%)(P<0.05);经过三个疗程后2组的神经功能评分均有上升,且治疗组的效果更明显(P<0.05);MRI检查示2组较用药前病灶范围减少,水肿减轻,治疗组改善更明显(P<0.05)。即经过三个疗程治疗后,两组患儿病情均有好转,且治疗组疗效更明显。结论神经营养类药物GM1联合胞磷胆碱通过修复、重构神经元、改善其代谢等促进受损的神经功能的恢复,在新生儿缺血缺氧性脑病的应用中具有良好的疗效。

关键词: 新生儿缺血缺氧性脑病, 单唾液酸四己糖神经节苷脂, 胞磷胆碱

Abstract: Objective To analysis the clinical therapeutic effect of monosialotetrahexosylganglioside and citicolineon neonatal hypoxic-ischemic encephalopathy, and explore its possible mechanism.Methods A total of 54 newborn with hypoxicischemic encephalopathy were enrolled from January 2015 to June 2017 in Guangzhou First People's Hospital, and they were divided into control group and treatment group according to the treatment methods, with 27 cases in the control group and 27 cases in the treatment group. Both groups were treated with conventional treatment, the control group added gangliosides, and the treatment group used ganglioside and citicoline. The clinical effects, neurological score and MRI were observed in the two groups.Results The total effective rate was 88.9% in the treatment group,which was higher than 73.0% in the control group (P<0.05). There was no significant difference on neurological score between the two groups before treatment (P>0.05). After treatment, the neurological scores of the two groups were significantly improved, and the score of the treatment group was higher than that of the control group (P<0.05). MRI examinations found that the lesions were significantly improved in the two groups after treatments, and the effect of the treatment group was higher than that of the control group (P<0.05).Conclusion Monosialotetrahexosylganglioside combined with citicolineinthe in treatment of newborn with hypoxicischemic encephalopathy has good effects through repairing and rebuilding the neurons, improving the metabolism to promote the recovery of neurological functions.

Key words: Neonatal hypoxicischemia encephalopathy, Monosialotetrahexosylganglioside, Citicoline

江美玲, 张又祥, 于力. 单唾液酸四己糖神经节苷脂联合胞磷胆碱治疗新生儿缺氧缺血性脑病的临床分析[J]. 广州医药, 2018, 49(2): 29-32.

JIANG Meiling, ZHANG Youxiang, YU Li. Clinical analysis of neonatal hypoxic-ischemic encephalopathy treated with ganglioside and citicoline[J]. Guangzhou Medical Journal, 2018, 49(2): 29-32.

参考文献

[1] MASSARO AN N, GOVINDAN R B, VEZINA GILBERT, et al. Impaired cerebral autoregulation and brain injury in newborns with hypoxic-ischemic encephalopathy treated with hypothermia[J]. J Neurophysiol, 2015, 114(2): 818-824.
[2] ZIEMKANALECZ M,JAWORSKA J,ZALEWSKA T. Insights Into the neuroinflammatory responses after neonatal hypoxia-ischemia[J]. J Neuropathol Exp Neurol, 2017, 76(8): 644-654.
[3] 崔彦存,刘翠青.新生儿缺氧缺血性脑病研究新进展[J].河北医药,2012,34(8):1237-1239.
[4] 中华医学会儿科学分会新生儿学组.新生儿缺氧缺血性脑病诊断标准[J].中国当代儿科杂志,2005,7(2):97-98.
[5] 鲍秀兰.新生儿行为能力和测查方法[J].实用诊断与治疗杂志,2003,17(6):441-443.
[6] ROCHA-FERREIRA E, PHILLIPS E, FRANCESCHD-OMENECH E, et al. The role of different strain backgrounds in bacterial endotoxin-mediated sensitization to neonatal hypoxic-ischemic brain damage[J]. Neurosci, 2015, 311: 292-307.
[7] ZHU X Y, YE M Y, ZHANG A M, et al. Influence of one-year neurologic outcome of treatment on newborns with moderate and severe hypoxic-ischemic encephalopathy by rhuEP0 combined with ganglioside (GM1)[J]. Eur Rev Med Pharmacol Sci, 2015, 19(20): 3955-3960.
[8] 孟璐璐.早产儿缺氧缺血性脑病的发病机制及诊断标准的探讨[J].医学综述,2012,18(1):73-75.
[9] 吴铭辉,史长松.新生儿缺氧缺血性脑病108例临床分析[J].中国实用神经疾病杂志,2014(14):30-31.
[10] DIXON B J, CESAR R, WING MANN H,et al. Neuroprotective strategies after neonatal hypoxic ischemic encephalopathy[J]. Int J Mol Sci, 2015, 16(9): 22368-22401.
[11] LV H Y, WU S J, Gu X L,et al. Predictive value of Neurodevelopmental outcome and serum tau protein level in neonates with hypoxic ischemic encephalopathy[J]. Clin Lab, 2017, 63(7): 1153-1162.
[12] 樊华.神经节苷酯治疗新生儿缺血缺氧性脑病的疗效及对其神经功能的影响[J]. 临床医学研究与实践,2017,2(16):42-43.
[13] XIONG M, CHEN L X, MA S M,et al. Short-term effects of hypothermia on axonal injury, preoligodendrocyte accumulation and oligodendrocyte myelination after hypoxia-ischemia in the hippocampus of immature rat brain[J]. Dev Neurosci, 2013, 35(1): 17-27.
[14] HARRIMAN TIFFANY, BRADSHAW WANDA T, BL-AKE STEPHANIE M. The use of whole body cooling in the treatment of hypoxic-ischemic encephalopathy[J]. Neonatal Netw, 2017, 36(5): 273-279.
[15] 黄鹏飞.单唾液酸四己糖神经节苷脂钠与胞二磷胆碱治疗轻中度新生儿缺血缺氧性脑病的效果[J].当代医药丛,2017,15(1):26-28.
[16] 徐毅.脑梗死患者分别接受长春西汀、胞二磷胆碱治疗对其脑功能恢复效果的临床观察[J].中外医学研究,2017,15(9):40-41.
[17] RAMIREZ M R, MURARO F, ZYLBERSZTEJN D S,et al. Neonatal hypoxia-ischemia reduces ganglioside, phospholipid and cholesterol contents in the rat hippocampus[J]. Neurosci. Res, 2003, 46(3): 339-347.
[18] RONG X,ZHOU W,XIAO W C,et al. Ganglioside GM1 reduces white matter damage in neonatal rats[J]. Acta Neurobiol Exp (Wars), 2013, 73(3): 379-386.
[19] 孙妍,李居龙,王竹颖.单唾液酸四己糖神经节苷脂对新生儿窒息并发缺血缺氧性脑病的疗效[J]. 解放军医药杂志,2015,(11):99-101,105.
[20] SCHUETTAUF F, REJDAK R, THALER S,et al. Citicoline and lithium rescue retinal ganglion cells following partial optic nerve crush in the rat[J]. Exp Eye Res, 2006, 83(5): 1128-1134.

单唾液酸四己糖神经节苷脂联合胞磷胆碱治疗新生儿缺氧缺血性脑病的临床分析

Clinical analysis of neonatal hypoxic-ischemic encephalopathy treated with ganglioside and citicoline

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