中国实用儿科杂志

中国实用儿科杂志

• 论著 • 上一篇    下一篇

神经节苷脂对早产儿脑白质损伤的临床疗效观察与分析

金轶1，王颖2，张欣2，周丛乐2，郭在晨2   

  1. 1.河北省邢台市人民医院儿科，河北邢台 054001，2.北京大学第一医院儿科，北京 100034
  • 收稿日期:2006-02-15 修回日期:2006-06-10 出版日期:2006-09-06 发布日期:2006-09-06

Observe and analyse the clinical curative effect of using GM1 on treating premature white matter damage.

Jin Yi,Wang Ying,Zhang Xin,et al.   

  1. Department of Pediatrics，the Pepole's Hosoital of Xingtai.Xingtai 054001,China
  • Received:2006-02-15 Revised:2006-06-10 Online:2006-09-06 Published:2006-09-06

摘要： 目的探讨神经节苷脂(GM1)在早产儿脑白质损伤治疗中的临床意义。 方法对入住北京大学第一医院新生儿ICU病房的早产儿于生后1周内常规行床旁头颅B超检查，将确诊为脑白质损伤(WMD)的89例患儿分为GM1治疗组及对照组。在积极治疗早产儿各项并发症的基础上，治疗组另给予GM1治疗，动态观察头颅B超的变化情况并进行随访。 结果在收治的356例早产儿中，确诊WMD的患儿89例，发生率为25%。第一疗程GM1治疗后，经头颅B超的动态观察，治疗组的56例均较对照组好转，差异有显著性(P<0.05)。治疗组中有33例患儿追踪至生后6个月，头颅超声显示16例出现了脑室扩大，占48%；2例出现了明显的智力及运动发育落后，约占6%；5例表现为限局性的肌张力、运动异常及轻微的认知障碍，占15%。对照组中有10例患儿追踪至生后6个月，8例出现脑室扩大，占80%；3例出现了明显的智力及运动发育落后，占30%；2例出现了轻微的认知及行为障碍，占20%。 结论GM1可减少脑白质软化及持续性病变的发生，改善预后。

关键词: 早产儿, 脑白质损伤, 头颅B超, 神经节苷脂

Abstract: AbstractObjectiveTo study on the clinical significance of GM1 in treating the premature white matter damage. MethodsAll premature infants who were hospitalized in NICU received routine bedside cranial sonography detection before 1 weekaged.Divide the confirmed patients into GM1 treating group and control group.The treating group consisted of 56 cases;control group of 33 cases.On the basis of being positive treated complicating disease,the treating group also accepted the treatment of GM1.Dynamically observe the changing of cranial sonography and follow up. ResultsOf 356 cases,89 were confirmed,and the proportion was 25%.After one course of treatment observe the recovery of cranial sonography.The treating group was better than the control group.The divergence had prominence.Thirtythree cases of treating group were followed up to 6 monthaged.Sixteen cases had ventriculus enlarging,covering 48%;2 cases of obvious locomotion and intelligence hypoevolutism;5 cases of localized abnormality of muscular tension 、 locomotion and slight disturbance of cognition.In control group,10 cases were followed to 6 monthaged.Eight cases occurred ventriculus enlarging,covering 80%.Three cases appeared obvious locomotion and intelligence hypoevolutism;2 cases occurred slight disturbance of cognition and behavior. ConclusionGM1 can decrease the occurrence of periventricular leukomalalia and continued white matter damage.

Key words: GM1 , White matter damage , Cranial sonography