磷酸肌酸钠治疗新生儿窒息后心肌损伤疗效分析
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摘要
目的探究磷酸肌酸钠对新生儿窒息后心肌损伤的治疗效果。方法选择2016年2月至2018年2月在自贡市妇幼保健院产科出生的184例窒息新生儿为研究对象,采用随机数表法将其分为对照组和观察组,每组各92例,对照组患儿采取新生儿窒息后常规治疗手段,观察组患儿在对照组基础上加用磷酸肌酸钠治疗,观察两组患儿治疗前后血管内皮生长因子(vascular endothelial growth factor,VEGF)、热休克蛋白(heat shock protein,HSP)70、肌酸激酶同工酶(creatine kinase isoenzymes,CK-MB)、肌钙蛋白T(troponin T,cTnT)水平及循环改善情况,比较两组患儿治疗后心功能指标和治疗效果。结果治疗前两组患儿VEGF、HSP70、CK-MB、cTnT水平均无明显差异(P_均> 0.05),治疗后VEGF、CK-MB、cTnT水平均明显下降(P_均<0.05),HSP70水平均明显上升(P <0.05),但观察组患儿VEGF、CK-MB、cTnT水平均明显低于对照组(P_均<0.05),HSP70水平高于对照组(P <0.05)。两组患儿治疗前心率(heart rate,HR)、呼吸频率(respiratory rate,RR)、血氧饱和度(oxygen saturation,SpO_2)均无明显差异(P_均> 0.05),治疗后HR、RR较治疗前均明显下降(P_均<0.05),SpO_2较治疗前均明显升高(P_均<0.05),观察组患儿RR、HR、SpO_2改善情况均显著优于对照组(P_均<0.05)。治疗后,观察组患儿心电图异常率及左心室射血分数、脑钠肽水平均明显低于对照组(P_均<0.05),治疗显效率和有效率均明显高于对照组(P_均<0.05)。结论磷酸肌酸钠治疗新生儿窒息后心肌损伤疗效显著,可将其作为治疗新生儿窒息后心肌损伤的临床用药。
Objective To explore the efficacy of sodium creatine phosphate in the treatment of cardiac injury in neonates with asphyxia. Method 184 cases of asphyxia newborn born in Zigong City Maternal and Child Health Hospital from February 2016 to February 2018 were selected as subjects. They were divided into control group and observation group by random number table method 92 cases in each group. Children in control group received conventional treatment after neonatal asphyxia. Children in observation group received intravenous infusion of sodium creatine phosphate on the basis of control group. Vascular endothelial growth factor(VEGF), heat shock protein(HSP) 70, and creatine kinase isoenzymes(CK-MB), troponin T(cTnT) levels and circulatory improvement before and after treatment were observed in the two groups, and cardiac function indexes and therapeutic effects were compared between the two groups after treatment. Result There were no signi?cant differences in VEGF, HSP70, CK-MB and cTnT levels between the two groups before treatment(P_(all)> 0.05). After treatment, the levels of VEGF, CK-MB and cTnT were signi?cantly decreased in the two groups(P_(all)< 0.05), and the level of HSP70 was signi?cantly increased(P < 0.05). However, VEGF, CKMB and cTnT levels in observation group were signi?cantly lower than those in control group(P_(all)< 0.05), and HSP70 levels were signi?cantly higher than those in control group(P < 0.05). The heart rate(HR), respiratory frequency(RR), oxygen saturation(SpO_2)between the two groups before treatment had no obvious difference(P_(all)> 0.05). After treatment, HR and RR were signi?cantly lower than before treatment(P_(all)< 0.05), SpO_2 was signi?cantly higher than before treatment(P_(all)< 0.05). The improvement of RR, HR and SpO_2 in observation group was better than that in control group(P_(all)< 0.05). After treatment, the electrocardiogram abnormality rate and left ventricular ejection fraction(LVEF), brain natriuretic peptide(BNP) levels were signi?cantly lower than control group(P_(all)< 0.05). The treatment ef?ciency and effective rate in observation group were signi?cantly higher than those in control group(P_(all)< 0.05). Conclusion Sodium creatine phosphate is effective in the treatment of cardiac injury in neonates with asphyxia. Sodium creatine phosphate can be used as a clinical drug for the treatment of cardiac injury in neonates with asphyxia.
Objective To explore the efficacy of sodium creatine phosphate in the treatment of cardiac injury in neonates with asphyxia. Method 184 cases of asphyxia newborn born in Zigong City Maternal and Child Health Hospital from February 2016 to February 2018 were selected as subjects. They were divided into control group and observation group by random number table method 92 cases in each group. Children in control group received conventional treatment after neonatal asphyxia. Children in observation group received intravenous infusion of sodium creatine phosphate on the basis of control group. Vascular endothelial growth factor(VEGF), heat shock protein(HSP) 70, and creatine kinase isoenzymes(CK-MB), troponin T(cTnT) levels and circulatory improvement before and after treatment were observed in the two groups, and cardiac function indexes and therapeutic effects were compared between the two groups after treatment. Result There were no signi?cant differences in VEGF, HSP70, CK-MB and cTnT levels between the two groups before treatment(P_(all)> 0.05). After treatment, the levels of VEGF, CK-MB and cTnT were signi?cantly decreased in the two groups(P_(all)< 0.05), and the level of HSP70 was signi?cantly increased(P < 0.05). However, VEGF, CKMB and cTnT levels in observation group were signi?cantly lower than those in control group(P_(all)< 0.05), and HSP70 levels were signi?cantly higher than those in control group(P < 0.05). The heart rate(HR), respiratory frequency(RR), oxygen saturation(SpO_2)between the two groups before treatment had no obvious difference(P_(all)> 0.05). After treatment, HR and RR were signi?cantly lower than before treatment(P_(all)< 0.05), SpO_2 was signi?cantly higher than before treatment(P_(all)< 0.05). The improvement of RR, HR and SpO_2 in observation group was better than that in control group(P_(all)< 0.05). After treatment, the electrocardiogram abnormality rate and left ventricular ejection fraction(LVEF), brain natriuretic peptide(BNP) levels were signi?cantly lower than control group(P_(all)< 0.05). The treatment ef?ciency and effective rate in observation group were signi?cantly higher than those in control group(P_(all)< 0.05). Conclusion Sodium creatine phosphate is effective in the treatment of cardiac injury in neonates with asphyxia. Sodium creatine phosphate can be used as a clinical drug for the treatment of cardiac injury in neonates with asphyxia.
引文
[1]马凤霞,褚景芝,赵宏静,等.磷酸肌酸钠治疗新生儿窒息后心肌损害的临床疗效观察[J].中外健康文摘,2013(45):106-107.
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[3]郑瑜.磷酸肌酸钠治疗窒息新生儿心肌损害的临床观察[J].中国临床医生,2013,41(1):42-43.
[4]Kalteren WS,Ter Horst HJ,den Heijer AE,et al.Perinatal anemia is associated with neonatal and neurodevelopmental outcomes in infants with moderate to severe peri natal asphyxia[J].Neonatology,2018,114(4):315-322.
[5]Espinoza ML,Cheung PY,Lee TF,et al.Heart rate changes during positive pressure ventilation after asphyxia-induced bradycardia in a porcine model of neonatal resuscitation[J].Arch Dis Child Fetal Neonatal Ed,2019,104(1):F98-F101.
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[7]Shikuku DN,Milimo B,Ayebare E,et al.Practice and outco mes of neonatal resuscitation for newborns with birth asphyxia at Kakamega County General Hospital,Kenya:a direct observation study[J].BMC Pediatr,2018,18(1):167.
[8]刘状.磷酸肌酸钠治疗慢性心力衰竭疗效及对患者血清相关细胞因子水平的影响[J].医学临床研究,2018,35(11):2164-2166.
[9]陈蕾,迟秀梅,李维江.产程中合理应用磷酸肌酸钠对新生儿Apgar评分及血气分析的影响探究[J].中国妇幼保健,2018,33(24):5847-5849.
[10]Benterud T,Manueldas S,Rivera S,et al.Cerebellum Susceptibility to Neonatal Asphyxia:Possible Protective Effects of N-Acetylcysteine Amide[J].Dis Markers,2018,2018:5046372.
[11]王芳.磷酸肌酸钠治疗新生儿窒息后心肌损害的疗效[J].中国实用医刊,2015,42(8):106-107.
[12]Biasucci G,Morelli N,Natacci F,et al.Early neonatal Glutaric aciduria type I hidden by perinatal asphyxia:a case report[J].Ital J Pediatr,2018,44(1):8.
[13]钱雪莲,赵君彦.新生儿窒息心肌损害采用磷酸肌酸钠综合治疗的疗效观察[J].临床医药文献电子杂志,2015,2(35):7277-7278.
[14]游森水,陈梅.磷酸肌酸钠治疗新生儿窒息后心肌损害疗效观察[J].中外医疗,2013,32(32):125-126.
[15]洪艳,姜赤秋.磷酸肌酸钠治疗新生儿窒息后心肌损害临床观察[J].医学理论与实践,2012,25(6):639-640.
[2]Parfenova H,Pourcyrous M,Fedinec AL.et al.Astrocyteproduced carbon monoxide and the carbon monoxide donor CORM-A1 protect against cerebrovascular dysfunction caused by prolonged neonatal asphyxia[J].Am J Physiol Heart Circ Physiol,2018,315(4):H978-H988.
[3]郑瑜.磷酸肌酸钠治疗窒息新生儿心肌损害的临床观察[J].中国临床医生,2013,41(1):42-43.
[4]Kalteren WS,Ter Horst HJ,den Heijer AE,et al.Perinatal anemia is associated with neonatal and neurodevelopmental outcomes in infants with moderate to severe peri natal asphyxia[J].Neonatology,2018,114(4):315-322.
[5]Espinoza ML,Cheung PY,Lee TF,et al.Heart rate changes during positive pressure ventilation after asphyxia-induced bradycardia in a porcine model of neonatal resuscitation[J].Arch Dis Child Fetal Neonatal Ed,2019,104(1):F98-F101.
[6]许秀金.磷酸肌酸钠治疗新生儿窒息后心肌损害临床体会[J].辽宁医学院学报,2015,36(2):72-74.
[7]Shikuku DN,Milimo B,Ayebare E,et al.Practice and outco mes of neonatal resuscitation for newborns with birth asphyxia at Kakamega County General Hospital,Kenya:a direct observation study[J].BMC Pediatr,2018,18(1):167.
[8]刘状.磷酸肌酸钠治疗慢性心力衰竭疗效及对患者血清相关细胞因子水平的影响[J].医学临床研究,2018,35(11):2164-2166.
[9]陈蕾,迟秀梅,李维江.产程中合理应用磷酸肌酸钠对新生儿Apgar评分及血气分析的影响探究[J].中国妇幼保健,2018,33(24):5847-5849.
[10]Benterud T,Manueldas S,Rivera S,et al.Cerebellum Susceptibility to Neonatal Asphyxia:Possible Protective Effects of N-Acetylcysteine Amide[J].Dis Markers,2018,2018:5046372.
[11]王芳.磷酸肌酸钠治疗新生儿窒息后心肌损害的疗效[J].中国实用医刊,2015,42(8):106-107.
[12]Biasucci G,Morelli N,Natacci F,et al.Early neonatal Glutaric aciduria type I hidden by perinatal asphyxia:a case report[J].Ital J Pediatr,2018,44(1):8.
[13]钱雪莲,赵君彦.新生儿窒息心肌损害采用磷酸肌酸钠综合治疗的疗效观察[J].临床医药文献电子杂志,2015,2(35):7277-7278.
[14]游森水,陈梅.磷酸肌酸钠治疗新生儿窒息后心肌损害疗效观察[J].中外医疗,2013,32(32):125-126.
[15]洪艳,姜赤秋.磷酸肌酸钠治疗新生儿窒息后心肌损害临床观察[J].医学理论与实践,2012,25(6):639-640.
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