Clinical effect of mild hypothermia combined with cattle encephalon glycoside and ignotin in the treatment of neonatal asphyxia brain injury and the influence on blood NO
MU Yanshun LIU Weijuan GAO Jialing LIU Hongwei FAN Qingman
Department of Pediatrics, Huabei Petroleum General Hospital, Hebei Province, Renqiu 062552, China
Abstract：Objective To investigate the clinical efficacy of mild hypothermia combined with cattle encephalon glycoside and ignotin in the treatment of neonatal asphyxia brain injury and its effect on blood NO. Methods A retrospective analysis of 62 neonates with moderate and severe asphyxia brain injury who admitted to Department of Pediatrics, Huabei Petroleum General Hospital from May 2018 to October 2019. According to the different treatment methods, they were divided into mild hypothermia combined with cattle encephalon glycoside and ignotin treatment group (31 cases) and the routine treatment group (31 cases). Symptomatic supportive treatment such as maintaining electrolyte balance, lowering intracranial pressure, anti-infection and nutritional support was given to children in routine treatment group. The children in mild hypothermia combined with cattle encephalon glycoside and ignotin treatment group were treated with mild hypothermia combined with cattle encephalon glycoside and ignotin on the basis of conventional treatment. The changes of neonatal behavioral neuropathy assessment (NBNA) were compared between two groups on 7, 14 d after treatment, and the dynamic changes of blood NO were monitored. Results There was no significant difference in NBNA score between two groups before treatment (P > 0.05). NBNA scores on 7, 14 d after treatment of two groups were higher than those before treatment, and mild hypothermia combined with cattle encephalon glycoside and ignotin treatment group was higher than routine treatment group, with statistically significant differences (all P < 0.05). There was no statistically significant difference in blood NO level between two groups before treatment (P > 0.05). Blood NO level on 7, 14 d after treatment of two groups were lower than those before treatment, and mild hypothermia combined with cattle encephalon glycoside and ignotin treatment group was lower than routine treatment group, with statistically significant differences (all P < 0.05). Conclusion Mild hypothermia combined with cattle encephalon glycoside and ignotin treatment can significantly improve NBNA score. The detection of serum NO is helpful to the judgment of brain injury after asphyxia.
穆艳顺 刘伟娟 高嘉陵 刘红伟 樊青曼. 亚低温联合脑苷肌肽治疗新生儿窒息脑损伤的临床效果及对血NO的影响[J]. 中国医药导报, 2020, 17(9): 99-102.
MU Yanshun LIU Weijuan GAO Jialing LIU Hongwei FAN Qingman. Clinical effect of mild hypothermia combined with cattle encephalon glycoside and ignotin in the treatment of neonatal asphyxia brain injury and the influence on blood NO. 中国医药导报, 2020, 17(9): 99-102.
[1] Satriano A，Pluchinotta F，Gazzolo F，et al. The potentials and limitations of neuro-biomarkers as predictors of outcome in neonates with birth asphyxia [J]. Early Hum Dev，2017，105：63-67.
[2] Nair J，Kumar VHS. Current and Emerging Therapies in the Management of Hypoxic Ischemic Encephalopathy in Neonates [J]. Children，2018，5（7）：99-116.
[3] Mitsialis SA， Kourembanas S. Stem cell-based therapies for the newborn lung and brain：Possibilities and challenges [J]. Semin Perinatol，2016，40（3）：138-151.
[4] Nabetani M， Shintaku H，Hamazaki T. Future perspectives of cell therapy for neonatal hypoxic-ischemic encephalopathy [J]. Pediatr Res，2018，83（1）：356-363.
[5] Edwards AD， Brocklehurst P， Gunn AJ，et al. Neurological outcomes at 18 months of age after moderate hypothermia for perinatal hypoxic ischaemic encephalopathy：synthesis and meta-analysis of trial data [J]. BMJ，2010，340：c363.
[6] Wang LS，Cheng GQ，Zhou WH，et al. Meta-analysis of mild hypothermia for gestational age over 35-week newborns with hypoxic-ischemic encephalopathy [J]. Zhonghua Yi Xue Za Zhi，2012，92：1400-1404.
[7] 江载芳，申昆玲，沈颖.诸福棠实用儿科学[M].8版.北京：人民卫生出版社，2015：468-471.
[8] Zhou W，Cheng G，Shao X，et al. Selective head cooling with mild systemic hypothermia after neonatal hypoxic-ischemic encephalopathy：a multicenter randomized controlled trial in China [J]. J Pediatr，2010，157（3）：367-372.
[9] 金汉珍，黄德珉，官希吉.实用新生儿学[M].3版.北京：人民卫生出版社，2006：57-65.
[10] Kim GW，Kondo T， Noshita N，et al. Manganese superoxide dismutase deficiency exacerbates cerebral infarction after focal cerebral ischemia/reperfusion in mice：implications for the production and role of superoxide radicals [J]. Stroke，2002，33（3）：809-815.
[11] Ferriero DM. Neonatal brain injury [J]. N Engl J Med，2004，351（9）：1985-1995.
[12] Favrais G，Van De Looij Y，Fleiss B，et al. Systemic inflammation disrupts the developmental program of white matter [J]. Ann Neurol，2011，70（4）：550-565.
[13] Leviton A，Gressens P. Neuronal damage accompanies perinatal white-matter damage [J]. Trends Neurosci，2007， 30（9）：473-478.
[14] Derganc M，Osredkar D. Hypoxic-ischemic brain injury in the neonatal period [J]. Zdrav Vestn，2008，77：51-54.
[15] Miller SP，Ramaswamy V，Michelson D，et al. Patterns of brain injury in term neonatal encephalopathy [J]. J Pediatr，2005，146：453-460.
[16] Silveira RC，Procianoy RS. Hypothermia therapy for newborns with hypoxic ischemic encephalopathy [J]. J Pediatr（Rio J），2015，91（6 Suppl 1）：S78-S83.
[17] Purkayastha J，Lewis LE， Bhat R，et al. Feasibility and Safety of Therapeutic Hypothermia and Short Term Outcome in Neonates with Hypoxic Ischemic Encephalopathy [J]. Indian J Pediatr，2016，83（2）：175-177.
[18] Montaldo P， Lally PJ， Oliveira V，et al. Therapeutic hypothermia initiated within 6 hours of birth is associated with reduced brain injury on MR biomarkers in mild hypoxic-ischaemic encephalopathy：a non-randomised cohort study [J]. Arch Dis Child Fetal Neonatal Ed，2019， 104（5）：F515-F520.
[19] Jia W，Lei X，Dong W，et al. Benefits of starting hypothermia treatment within 6 h vs. 6-12 h in newborns withmoderate neonatal hypoxic-ischemic encephalopathy [J]. BMC Pediatr，2018，18（1）：50.
[20] Hifumi T，Kawakita K，Okazaki T，et al. Indication for mild therapeutic hypothermia based on an initial Glasgow Coma Scale motor score [J]. J Intensive Care，2015， 3（1）：45.
[21] Azzopardi D，Strohm B，Marlow N，et al. Effects of hypothermia for perinatal asphyxia on childhood outcomes [J]. N Engl J Med，2014，371（2）：140-149.
[22] Kitai Y，Ohmura K，Hirai S，et al. Long-term outcome of childhood hypoxic-ischemic encephalopathy [J]. No To Hattatsu，2015，47（1）：43-48.
2020, Vol. 17 
京公网安备 11010502046598号