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医学论文范文:硫酸镁联合多巴胺治疗新生儿缺氧缺血性脑病的临床研究
【摘要】 目的 探讨硫酸镁联合多巴胺对新生儿缺氧缺血性脑病(HIE)的脑保护作用。方法 将60例患儿随机分为硫酸镁联合多巴胺组(D)、单用硫酸镁组(L)、生理盐水组(C)三组，同时设立正常对照组(N)，分别测定各组入院时及入院后48 h、72 h 和7天各时间点血清S100β蛋白、肌酸激酶脑型同工酶(CK-BB)，并于治疗期间监测患儿呼吸、心率和血压的变化。结果 D组和L组患儿入院后48 h、72 h与7天时血S100β蛋白、CK-BB浓度增加明显小于C组(P<0.01，P<0.05)，D组患儿呼吸抑制、心率和血压变化的发生率明显低于L组。结论 硫酸镁联合多巴胺对HIE患儿有脑保护作用，同时减少了单用硫酸镁的不良反应。
【关键词】 硫酸镁;多巴胺;新生儿缺氧缺血性脑病
Effects of magnesium sulfate combined with dopamine on hypoxic-ischemicencephalopathy in neonatesYANG Lijuan, YANG Xiaochun, YUAN Yufang(The Affiliated Huai′an First Hospital of Nanjing Medical University, Huai′an, Jiangsu 223300, China)Abstract： Objective To investigate the protective effect of magnesium sulfate combined with dopamine on the brain of neonates with hypoxic-ischemic encephalopathy (HIE). Methods 60 neonates with HIE were randomly divided into magnesium sulfate with dopamine group (D), magnesium sulfate alone group (L) and normal saline group (C) to contrast with the normal control group (N). Serum levels of creatine phosphokinase isoenzyme BB (CK-BB) and S-100β protein were observed in the 4 groups at different time points (admission and 48 h, 72 h and 7 days of hospitalization). The variations in respiration rate, heart rate and blood pressure were monitored during the treatment.Results Compared with group N, the increase in serum levels of CK-BB and S100β protein in groups D and L was evidently smaller than that in group C (P<0.01, P<0.05), and group D had a lower incidence of respiratory depression, variations in heart rate and blood pressure than group L. Conclusion Magnesium sulfate combined with dopamine significantly protects neonates with HIE from brain insult, without the adverse reactions caused by the administration of magnesium sulfate alone.
Key words：magnesium sulfate; dopamine; hypoxic-ischemic encephalopathy
新生儿缺氧缺血性脑病(hypoxic-ischemic encephalopathy，HIE)是导致新生儿早期死亡和影响远期神经预后的重要疾病，发病机制十分复杂，临床治疗也颇多争议，尤其远期神经系统预后一直是困扰临床的棘手问题。尽管有关HIE防治的研究颇多，但目前仍未取得明显突破。最近我们用神经保护药硫酸镁联合中小剂量的多巴胺治疗HIE取得较好的临床效果,报告如下医学 全在.线提供www.med126.com。
1 资料和方法
1.1 一般资料 我科新生儿监护病房(NICU)2006年9月—2008年12月收治的临床分度为中、重度的HIE[1]患儿60例，排除药物等因素引起新生儿抑制或心、肺、脑等先天畸形而致神经系统异常者;均为足月儿，胎龄 37～42周,出生体重 2.5～4.0 kg，均系生后 6 h内转入NICU。
