【摘要】 目的评价神经节苷脂GM1(GM1)治疗新生儿缺氧缺血性脑病(HIE)对患儿急性期及远期神经发育的影响。方法将51例中度HIE患儿分为GM1治疗组(n=27)和对照组(选用1,6-二磷酸果糖或脑活素治疗,n=24)。新生儿期采用NBNA评分,随访期间每3个月采用Gesell量表法对其进行发育评价,对出现神经系统异常者给予相应的康复训练。结果治疗组中死亡1例,失访2例,随访的24例中神经系统发育异常者8例,包括适应性异常3例、大运动异常5例、精细运动异常4例、语言异常3例、个人-社交异常2例；对照组中死亡1例,失访4例,19例随访病人中神经系统发育异常者8例,包括适应性异常4例、大运动异常5例、精细运动异常5例、语言异常6例、个人-社交异常4例。两组Gesell在总均值和语言方面存在显著性差异(P＜0.05),且在9月龄随访时两组Gesell均值在语言方面也存在显著性差异(P＜0.05)。结论早期应用GM1治疗新生儿HIE可以减轻HIE所致的神经系统发育障碍。更多还原

【Abstract】 Objective To evaluate curative effect of ganglioside GM1 (GM1) on neonatal hypoxic-ischemic encephalopathy (HIE) and its long-term effect on nerve behavioral development of infants with HIE. Methods Fifty-one neonates with moderate HIE were divided into two groups: GM1 treated group(n=27) and control group (n=24). The score of neonatal behavioral neurological assessment (NBNA) was evaluated in acute phase of brain injury. Babies were followed up every three month and Gesell development schedule was used to evaluate their neurodevelopment in convalescence phase. Infants with neurological sequelae were intervened in follow-up phase. Results Twenty-four GM1 treated babies were followed up (one died and two lost of follow-up). Eight of them had abnormal neuro-behavioral development, 3 adaptive behavior abnormity, 5 gross motor abnormity, 4 fine motor abnormity, 3 language abnormity and 2 personal-social behavior abnormity. In control group (1 died and 4 lost of follow-up), 8 of 19 patients had abnormal neuro-behavioral development, including 4 adaptive behavior abnormity, 5 gross motor abnormity, 5 fine motor abnormity, 6 language abnormity and 4 personal-social behavior abnormity. Tthere was significant difference in The Mean Gesell score of global and language development between GM1 treated group and control group(P＜0.05). The difference in the Mean Gesell score of language development between two groups kept until 9 montls follow-up (P＜0.05). Conclu- sions GM1 administ ration has early and prolonged benift to the patient with HIE.更多还原