【摘要】 目的:监测新生儿缺氧缺血性脑病(HIE)血清钙、NO、NSE、S100B的水平变化,进一步采用神经节苷脂钠干预,证实神经节苷脂钠在新生儿HIE治疗中临床应用价值及前景。方法:设对照组为非HIE患儿(无窒息、无重度感染),并依次设常规治疗组和神经节苷脂钠治疗组,采用偶氮砷终点法、硝酸还原酶法及化学放光免疫法对生后7天及不同程度HIE患儿进行血清钙、NO、NSE、S100B水平检测。结果:新生儿HIE组血清钙较对照组降低,NSE和S100B明显高于对照组,差异有统计学意义(P<0.01);与轻度组相比,中、重度HIE组血清钙含量降低,血清NO、NSE和S100B含量增高,且组间差异有统计学意义(P<0.01);经神经节苷脂钠治疗组与常规治疗组相比,神经节苷脂钠治疗后,HIE新生儿血清钙、NO、NSE和S100B较常规治疗组浓度变化明显,差异有统计学意义(P<0.01)。结论:血清NO、NSE和S100B水平在HIE发病机制中起一定作用,其水平的增高与该病的严重程度相关,可作为早期辅助诊断HIE及判定病情严重程度的可靠指标;神经节苷脂钠可降低HIE所致的脑细胞损伤,具有重要的临床价值及应用前景。更多还原

【Abstract】 Objective: To monitor the changes of serum calcium,nitric oxide( NO),neuron-specific enolase( NSE) and S100 B levels in neonates with hypoxic-ischemic encephalopathy( HIE),further adopt ganglioside sodium intervention to confirm the clinical application value and prospect of ganglioside sodium in treatment of neonatal HIE. Methods: The neonates without asphyxia and severe infection were selected as control group; the neonates with HIE treated with routine therapy and ganglioside sodium respectively were selected as routine therapy group and ganglioside sodium group; arsenazo endpoint method,nitrate reductase method and chemiluminescence immunoassay were used to detect serum calcium,NO,NSE and S100 B levels in HIE neonates of different degrees on the seventh day after birth. Results:Serum calcium level in neonatal HIE group was statistically significantly lower than that in control group,while serum NSE and S100 B levels in neonatal HIE group were statistically significantly higher than those in control group( P < 0. 01); compared with mild HIE group,serum calcium levels in moderate HIE group and severe HIE group decreased,serum NO,NSE and S100 B levels in moderate HIE group and severe HIE group increased,there were statistically significant differences( P < 0. 01); compared with routine therapy group,the changes of serum calcium,NO,NSE and S100 B levels in ganglioside sodium group were more obvious,there were statistically significant differences( P <0. 01). Conclusion: Serum NO,NSE and S100 B levels play certain roles in pathogenesis of HIE,the increases of NO,NSE and S100 B levels are correlated with severity of the disease,which can be used as reliable indexes for early auxiliary diagnosis of HIE and predicting severity of the disease; ganglioside sodium can reduce brain cells injury induced by HIE,which has important clinical value and application prospect.更多还原