李哲?吴昔林?农定猛?方座华

[摘要] 目的 观察单唾液酸四己糖神经节苷酯（GM1）结合丹参注射液治疗足月新生儿缺氧缺血性脑病（HIE）的临床疗效。 方法 将105例足月HIE患儿随机分为治疗组（常规治疗加GM1和丹参注射液）52例及对照组（常规治疗加胞二磷胆碱）53例治疗3疗程， 观察患儿治疗前后行为神经评分（NBNA）和总体临床疗效以及1周岁时预后和精神运动发育商（DQ）等指标。 结果 治疗后治疗组较对照组NBNA、总体临床疗效、1周岁时的DQ均有不同程度的改善（P<0.05）。结论 GM1结合丹参注射液对HIE患儿有较好的近期治疗作用和改善较远期的预后，值得临床推广。

[关键词] 单唾液酸四己糖神经节苷酯；丹参注射液；足月新生儿缺氧缺血性脑病；行为神经评分；精神运动发育商

[中图分类号] R742 [文献标识码] A [文章编号] 2095-0616（2017）10-52-04

Observation of clinical curative effect of monosialotetrahexosy-lganglioside combined with salvia injection on hypoxic ischemic encephalopathy of term neonates

LI Zhe1 WU Xilin2 NONG Dingmeng2 FANG Zuohua3

1.Department of Pediatrics， Dongguan Rehabilitation Hospital of Guangdong， Guangdong， Dongguan 523119， China； 2.Department of Pediatrics， Liaobu Hospital of Dongguan， Guangdong， Dongguan 523400， China； 3.Neonatal Department， Dongguan Hospital of Traditional Chinese Medicine， Guangdong， Dongguan 523006， China

[Abstract] Objective To observe clinical curative effect of monosialotetrahexosylganglioside （GM1） combined with salvia injection on hypoxic ischemic encephalopathy （HIE） of term neonates. Methods 105 term neonates with HIE were randomly divided into the treatment group with 52 cases and the control group with 53 cases. The treatment group was given routine treatment combined with salvia injection while the control group was given routine treatment combined with citicoline. Neonatal behavior neurological assessment （NBNA）， total clinical curative effect， prognosis and psychomotor developmental quotient （DQ） of one year old and other indexes before and after treatment of term neonates were observed. Results NBNA， total clinical curative effect and DQ of one year old were all had different degrees of improvement （P<0.05）. Conclusion GM1 combined with salvia injection has a better recent treatment effect on term neonates with HIE and it can improve long-term prognosis， which is worthy of clinical promotion.

[Key words] Monosialotetrahexosylganglioside； Salvia injection； Term neonates with HIE； Neonatal behavior neurological assessment； Developmental quotient

新生兒缺氧缺血性脑病（hypoxic-ischemic encephalopathy，HIE）是指因各种围生期高危因素所致新生儿窒息，进而使中枢神经系统受损[1]。HIE是新生儿窒息后的严重并发症，临床可出现意识状态，肌肉张力及原始反射异常等一系列中枢神经系统异常表现，严重的HIE患儿可有脑瘫、认知障碍、癫痫等后遗症，它是导致新生儿死亡和婴幼儿神经系统功能障碍的主要原因[2-3]，如何提高对HIE的临床治疗效果，对降低新生儿死亡率、致残率具有重要意义。本课题组回顾分析运用单唾液酸四己糖神经节苷酯（GM1）结合丹参注射液治疗足月HIE患儿，取得一定的疗效，现报道如下。

1 资料与方法

1.1 一般资料

收集2013年6月～2016年3月符合入选标准病例105例， 其中， 男58例， 女47例；年龄最小1d， 最大4d，平均（2.02±0.83）d，将105例病例随机分为治疗组52例和对照组53例，对照组男28例，女25例，平均年龄（2.08±0.66）岁，CT检查：轻度13例，中度24例，重度16例，Apgar评分（5.11±0.56）；……