摘要
目的探讨高压氧对新生儿缺氧缺血性脑病(HIE)氧化应激反应、新生儿行为神经评分(NBNA)及脑损伤的影响。方法回顾性分析于2018-03—2023-03遂宁市中心医院出生的114例HIE患儿的临床资料,根据治疗计划分组,将使用常规综合性治疗的55例患儿纳入对照组,加用高压氧治疗的59例患儿纳入观察组。对比2组患儿治疗效果,观察治疗前后2组氧化应激反应[超氧化物歧化酶(SOD)、一氧化氮(NO)、丙二醛(MDA)]、NBNA评分、血液流变学指标[全血黏度(WBV)、红细胞比积(HCT)、血浆黏度(PV)、血小板聚集指数(PAI)]及脑血流速度变化情况。结果治疗后,观察组临床有效率显著高于对照组(83.05%比50.91%,P<0.05)。2组MDA、PV、HCT、WBV、PAI和大脑中动脉PI水平均低于治疗前,SOD、NO和大脑中动脉Vm、Vs、Vd均高于治疗前,且观察组MDA、PV、HCT、WBV、PAI较对照组低,SOD、NO和大脑中动脉Vm、Vs、Vd均较对照组高(P<0.05)。各时间点2组患者NBNA评分相较于治疗前均显著提高,观察组治疗后3、6、12个月NBNA评分明显高于对照组(P<0.05)。结论高压氧对HIE患儿氧化应激反应、血液流变学指标和脑血流速度明显改善,NBNA评分显著提高,有利于改善新生儿神经行为功能。
Objective To investigate the effect of hyperbaric oxygen on oxidative stress response,neonatal behavioral neurological assessment(NBNA)score and brain injury in children with neonatal hypoxic-ischemic encephalopathy(HIE).Methods The clinical data of 114 children with HIE from March 2018 to March 2023 in the Suining Central Hospital were retrospectively analyzed.According to the treatment plans,55 children receiving conventional comprehensive treatment were included in the control group,and 59 children with additional hyperbaric oxygen therapy were enrolled as observation group.The therapeutic effect,oxidative stress response(superoxide dismutase(SOD),nitric oxide(NO),malondialdehyde(MDA)),NBNA score,hemorheological indicators(whole blood viscosity(WBV),hematocrit(HCT),plasma viscosity(PV),platelet aggregation index(PAI))and cerebral blood flow velocity were compared between the two groups.Results After treatment,the clinical effective rate in observation group(83.05%)was significantly higher than that in control group(50.91%,P<0.05).The levels of MDA,PV,HCT,WBV,PAI and middle cerebral artery PI in the two groups were lower than before treatment,SOD,NO,Vm,Vs and Vd in middle cerebral artery were higher than before treatment,and MDA,PV,HCT,WBV and PAI in observation group were lower than those in control group.SOD,NO,Vm,Vs and Vd of middle cerebral artery were higher than those of control group(P<0.05).Compared with before treatment,the NBNA scores of the two groups were significantly improved at each time point,and the NBNA scores of the observation group were significantly higher than those of the control group at 3,6 and 12 months after treatment(P<0.05).Conclusion Hyperbaric oxygen can significantly improve the oxidative stress response,hemorheological indicators and cerebral blood flow velocity,and significantly enhance the NBNA score in children with HIE.
作者
黄久浪
彭好
李琴
陈龙英
何云霞
HUANG Jiulang;PENG Hao;LI Qin;CHEN Longying;HE Yunxia(Suining Central Hospital,Suining 629000,China)
出处
《中国实用神经疾病杂志》
2024年第12期1548-1552,共5页
Chinese Journal of Practical Nervous Diseases
基金
四川省医学(青年创新)科研课题(编号:S19015)。
关键词
高压氧
新生儿缺氧缺血性脑病
氧化应激
脑损伤
NBNA评分
Hyperbaric oxygen
Neonatal hypoxic-ischemic encephalopathy
Oxidative stress
Brain injury
NBNA score
