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。

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.

目的 观察单唾液酸四己糖神经节苷脂联合复方丹参片在治疗难治性癫痫的脑保护作用。方法 选取2010年1月—2015年10月于我院进行治疗的80例难治性癫痫患者为研究对象,随机分为对照组和治疗组。对照组患者给予常规抗癫痫药物治疗,而治疗组患者在对照组治疗基础上给予单唾液酸四己糖神经节苷脂联合复方丹参片治疗。治疗一疗程后,对两组患者进行疗效判定;并分别在治疗前后使用韦氏成人智力量表(WAIS-RC)和韦氏记忆量表(WMS-RC)对两组患者的智商和记忆商进行测评,并比较分析。结果 ①观察组患者的治疗总有效率为97.5%高于对照组的87.5%(P<0.05)。②治疗后,观察组患者的语言智商、操作智商、总智商和记忆商得分分别为(95.4±8.5)分、(94.8±12.5)分、(92.8±7.5)分和(93.5±8.2)分,均高于治疗前的(89.5±7.2)分、(91.5±10.1)分、(88.5±6.9)分和(82.5±10.0)分,且也均高于对照组治疗后的(75.4±6.8)分、(80.6±9.8)分、(80.1±5.9)分和(76.9±8.2)分,以上差异均有统计学意义(P<0.05)。治疗后,对照组患者的智商和记忆商均见的下降,均低于治疗前各分数,以上差异有统计学意义(P<0.05)。结论 神经节苷脂联合复方丹参片治疗难治性癫痫临床效果显著,且具有一定的脑保护效果,可为以后临床治疗难治性癫痫患者提供参考依据。

Objective To observe the cerebral protective effects of monomial four hexose ganglioside combined with compound salvia miltrorrhiza tablets (CSMT) in patients with refractory epilepsy. Methods 80 patients with refractory epilepsy patients treated in our hospital between January 2010 and October 2015 were randomly divided into control group and treatment group. The control group patients were treated with conventional antiepileptic drug therapy, and the treatment group patients were treated with monomial four hexose ganglioside, CSMT and conventional antiepileptic drug therapy. The efficacy in two groups' patients was determined after a course of treatment. The IQ and memory quotient in two groups' patients before and after treatment were evaluated by the Wechsler Adult Intelligence Scale (WAIS-RC) and the Wechsler Memory Scale (WMS-RC) respectively and comparative analysed. Results ①The total effective rate in the treatment group (97.5%) was significantly higher than that in the control group (87.5%) (P<0.05). ②The verbal IQ (95.4±8.5), performance IQ (94.8 ± 12.5), total IQ (92.8 ± 7.5) and memory quotient (93.5 ± 8.2) scores in the treatment group after treatment were significantly higher than those before treatment (89.5 ± 7.2), (91.5 ± 10.1), (88.5 ± 6.9), (82.5 ± 10.0) respectively, and also were significantly higher than those in the control group after treatment (75.4 ± 6.8), (80.6 ± 9.8), (80.1 ± 5.9) and (76.9 ± 8.2) respectively (P<0.05). The IQ and memory quotient in the control groups' patients after treatment were significantly decline and lower than before treatment, which had a statistically significant difference (P<0.05). Conclusion Ganglioside combined with CSMT in the treatment of refractory epilepsy can receive significant clinical effect and own a certain brain protective effect, which provide reference to the future clinical treatment of refractory epilepsy patients.