Efficacy of monosialotetrahexosyl ganglioside combined with recombinant human erythropoietin in the treatment of neonates with hypoxic-ischemic encephalopathy
10.7683/xxyxyxb.2024.09.010
- VernacularTitle:单唾液酸四己糖神经节苷脂联合重组人促红细胞生成素治疗新生儿缺氧缺血性脑病疗效观察
- Author:
Jing ZHANG
1
;
Yafang REN
;
Yan WANG
;
Pin WANG
;
Yue WANG
Author Information
1. 南阳市中心医院新生儿科,河南 南阳 473009
- Keywords:
recombinant human erythropoietin;
monosialotetrahexosyl ganglioside;
neonate;
hypoxic-ischemic encepha-lopathy;
hypoxia inducible factor-1α;
neuron specific enolase
- From:
Journal of Xinxiang Medical College
2024;41(9):857-861
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical effect of monosialotetrahexosyl ganglioside(GM1)combined with recombinant human erythropoietin(rhEPO)in treating neonates with hypoxic-ischemic encephalopathy(HIE)and its influence on inflammatory factors and neurological function.Methods A total of 78 neonates with HIE admitted to the Department of Neonatology of Nanyang Central Hospital from June 2017 to June 2020 were selected as the research subjects,and they were divided into the control group(n=39)and the observation group(n=39)by random number table method.All neonates were given routine treatment,including oxygen inhalation,maintenance of water,electrolyte and acid-base balance,control of convulsions and intracranial pressure,and moderate and severe HIE neonates were given mild hypothermia therapy on this basis.Neonates in the control group were given rhEPO 200 IU·kg-1 via subcutaneous injection on the basis of routine treatment,3 times a week.Neonates in the observation group were given GM1 20 mg intravenously once a day on the basis of the treatment of the control group.Seven days were taken as one course of treatment,and four courses of continuous treatment were taken.Moderate and severe HIE neonates were treated for 1-3 courses additionally according to their condition.The total effective rate of the two groups after treatment was compared.The neurological function of neonates in the two groups was evaluated by neonatal behavioral neurological assessment(NBNA)before,14 and 28 days after the treatment.The interleukin-6(IL-6),intercellular adhesion molecule-1(ICAM-1),tumor necrosis factor-α(TNF-α),hypoxia inducible factor-1α(HIF-1α)and neuron specific enolase(NSE)in the serum were measured by enzyme-linked immunosorbent assay before,14 and 28 days after the treatment.Results The total effective rate of treatment in the control group and the observation group was 69.23％(27/39)and 94.87％(37/39),respectively;the total effective rate of the observation group was significantly higher than that in the control group(x2=8.705,P=0.003).The total effective rate of treatment for mild HIE neonates in both groups was 100％.The total effective rate of moderate and severe HIE neonates in the observation group was significantly higher than that in the control group(x2=4.843,3.898,P=0.028,0.048).There was no significant difference in NBNA scores between the two groups before treatment(P＞0.05).The NBNA scores of neonates in the two groups were significantly higher on the 14 and 28 days after treatment(P＜0.05).The NBNA scores of the two groups were significantly higher on the 28 day after treatment than those on the 14 day after treatment(P＜0.05).The NBNA scores of the neonates in the observation group were significantly higher than those in the control group on the 14 and 28 days after treatment(P＜0.05).There was no significant difference in serum ICAM-1,IL-6,TNF-α,HIF-1α and NSE levels between the two groups before treatment(P＞0.05).The serum ICAM-1,IL-6,TNF-α,HIF-1α and NSE levels in the two groups on the 14 and 28 days after treatment were significantly lower than those before treatment(P＜0.05);the levels of serum ICAM-1,IL-6,TNF-α,HIF-1α and NSE in the two groups were significantly lower on the 28 day after treatment than those on the 14 day after treatment(P＜0.05).On the 14 and 28 days after treatment,the serum ICAM-1,IL-6,TNF-α,HIF-1α and NSE levels of the neonates in the observation group were significantly lower than those of the control group(P＜0.05).Conclusion GM 1 combined with rhEPO in the treatment of neonatal HIE can reduce the levels of inflammatory factors,serum HIF-1α and NSE,and promote the recovery of neurological function,with significant effects.
