摘要
目的评价神经节苷脂GM1在早期综合干预中对改善神经元特异性烯醇化酶(NSE)测定阳性的宫内发育迟缓(IUGR)儿预后的作用。方法选择2005年1月—2007年10月间出生的IUGR儿,在新生儿娩出时立即抽取脐血,采用ELISA法测定NSE水平,将NSE水平有明显升高的54例患儿列为研究对象,并随机分为干预组(29例)和对照组(25例)。两组均进行早期干预及康复治疗,干预组则在此基础上加用神经节苷脂GM120mg/d,静脉注射,10d为1疗程,共3～6个疗程。新生儿期采用NBNA评分,1岁及2岁时评价两组干预后智力发育指数(MPI)和心理运动发育指数(PDI)。结果干预组1、2岁时MDI和PDI均高于对照组,差异有统计学意义(P<0.01);干预组后遗症发生率为6.9%,对照组为24.0%,两组差异有统计学意义(P<0.05)。结论 NSE水平与脑损伤有关,GM1参与早期干预可促进可能存在脑损伤的IUGR患儿智力发育,预防及降低神经系统后遗症,改善IUGR患儿预后。
Objective To evaluate curative effect of ganglioside GM1 in early comprehensive intervention on newborns of intrauterine growth retardation（IUGR） with positive neuron-specific enolase（NSE） in umbilical cord blood and its long-term effect on nerve behavioral development of infants.Methods A total of 54 IUGR infants born between January 2005 and October 2007 were enrolled in this study.The samples of umbilical cord blood were collected at delivery time and the NSE levels were measured by enzyme linked immunosorbent assay（ELISA）.Those with positive NSE were randomly divided into two groups：the intervention group（GM1 treated group,n = 29） and control group（n = 25）.Infants in the two groups were all conducted early intervening and rehabilitation training,but the intervention group were given GM1 therapy（20 mg /d,intraveneously 10 days are one period of treatment,3-6 periods in all）.The score of neonatal behavioral neurological assessment（NBNA） was evaluated in neonatal period,mental development index（MDI） and psychokinesis development index（PDI） were evaluated at the ages of one and two years old.Therapeutic effects of two groups were compared.Results MDI and PDI score of intervention group were significantly higher than that of the control group（P〈0.01）.The incidence of sequela of intervention group is 6.9% while 24.0% in control group（P〈0.05）.Conclusions The NSE level correlates with brain injury.So early treatment of ganglioside GM1 in early comprehensive intervention may have an beneficial effect on IUGR newborns who may have brain injury,and decrease the incidence of nervous system＇s sequela.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2010年第8期735-737,共3页
Journal of Clinical Pediatrics
