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促红细胞生成素联合纳洛酮治疗恢复期新生儿缺氧缺血性脑病的疗效及对血清炎症因子的影响 被引量:8

Effect of erythropoietin combined with naloxone on serum inflammatory cytokines levels in neonates with hypoxic ischemic encephalopathy during recovery period
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摘要 目的:探讨促红细胞生成素(EPO)联合纳洛酮治疗恢复期新生儿缺氧缺血性脑病(HIE)的疗效及对血清细胞因子的影响。方法:选取2017年1—12月重庆医科大学附属儿童医院收治的60例HIE恢复期新生儿,随机分为观察组和对照组,每组30例。对照组采用康复功能联合EPO治疗,观察组在对照组基础上加予纳洛酮治疗。比较两组临床疗效及治疗前、后血清神经肽Y(NPY)、β-内啡肽(β-EP)、神经元特异性烯醇化酶(NSE)、超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)水平,并与同期健康新生儿(正常组)进行比较。结果:观察组治疗总有效率为93.33%,明显高于对照组的73.34%(P<0.05)。两组病死率比较,差异无统计学意义(P>0.05)。治疗3d、7d、14d后,观察组新生儿神经行为测定(NABA)评分高于对照组(均P<0.05)。治疗后,观察组反射、肌张力与意识恢复时间短于对照组,血清NPY、β-EP、NSE、hs-CRP、IL-6及TNF-α水平均明显低于对照组(均P<0.05),并接近正常组(P>0.05)。结论:EPO联合纳洛酮治疗恢复期新生儿HIE疗效显著,能明显降低血清NPY、β-EP、NSE及炎症因子水平。 Objective:To investigate the effect of erythropoietin(EPO)combined with naloxone on serum inflammatory cytokines levels in neonates with hypoxic ischemic encephalopathy(HIE).Methods:Sixty neonates with HIE during recovery period in our hopital from January 2017 to December 2017 were enrolled and randomly divided into an observation group and a control group,with 30 cases in each group.Healthy newborns in the same period were defined as a normal group.The neonates in the control group were treated with rehabilitation combined with EPO,and those in the observation group were treated as the control group with addition of naloxone.The clinical efficacy and serum levels of neuropeptide Y(NPY),β-endorphin(β-EP),neuron-specific enolase(NSE),sensitive C-reactive protein(hs-CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were compared.Results:The total effective rate in the observation group was 93.33%,which was significantly higher than that in the control group(73.34%)(P<0.05),and there was no significant difference in mortality between the two groups(P>0.05).After 3,7 and 14 days of treatment,the neonatal neurobehavioral determination(NABA)score in the observation group was higher than that in the control group(P<0.05).The levels of NPY,P-EP,NSE,hs-CRP,IL-6 and TNF-α in the control group were significantly lower than those in the control group(P<0.05),and these indexes were similar in the observation group and the normal group(P>0.05).Conclusion:EPO combined with naloxone is effective in the treatment of HIE in neonates,and it can significantly reduce the levels of serum NPY,β-EP,NSE and inflammatory factors during recovery period.
作者 肖惋翡 冉丽红 赵黎丽 沈芙蓉 Wanfei;Ran Lihong;Zhao Lili;Shen Furong(University-town Hospital of Chongqing Medical University,Chongqing 400131,China;Children’s Hospital of Chongqing Medical University,Chongqing 400000,China)
出处 《广西医科大学学报》 CAS 2019年第11期1797-1801,共5页 Journal of Guangxi Medical University
关键词 促红细胞生成素 纳洛酮 缺氧缺血性脑病 疗效 炎症因子 erythropoietin naloxone hypoxic ischemic encephalopathy efficacy inflammatory factor
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