中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2017, Vol. 12 ›› Issue (10): 1655-1663.doi: 10.4103/1673-5374.217338

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

促红细胞生成素联合亚低温对缺氧缺血性脑病新生儿血清Tau蛋白水平及神经发育结局的影响

  

  • 收稿日期:2017-09-27 出版日期:2017-10-15 发布日期:2017-10-15
  • 作者简介:
  • 基金资助:

     河北省卫计委项目（20150033），邯郸市科技研究与发展项目（152810879-6）

Effect of erythropoietin combined with hypothermia on serum tau protein levels and neurodevelopmental outcome in neonates with hypoxic-ischemic encephalopathy

 Hong-yan Lv1, 2, Su-jing Wu1， Qiu-li Wang1, Li-hong Yang1, Peng-shun Ren1, Bao-jun Qiao1, Zhi-ying Wang1, Jia-hong Li1, Xiu-ling Gu3, Lian-xiang Li2, 4   

  1. 1 Department of Neonatology, Handan Maternal and Child Health Care Hospital, Handan, Hebei Province, China
    2 Department of Neonatal Pathology, Handan Maternal and Child Health Care Hospital, Handan, Hebei Province, China
    3 Department of Children’s Rehabilitation, Handan Maternal and Child Health Care Hospital, Handan, Hebei Province, China
    4 Department of Neural Development and Neural Pathology, Hebei University of Engineering School of Medicine, Handan, Hebei Province, China
  • Received:2017-09-27 Online:2017-10-15 Published:2017-10-15
  • Contact: Lian-xiang Li,lianxianglm68@163.com.
  • Supported by:

      This study was supported by a grant from the Health and Family Planning Commission of Hebei Province of China, No. 20150033; a grant from the Science and Technology Research and Development Project of Handan City of Hebei Province of China, No. 152810879-6.

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摘要：

虽然亚低温能有效治疗新生儿缺氧缺血性脑病，但仍有有很多患者死亡或留下严重的神经功能障碍的病例。由于促红细胞生成素被认为是一种有潜力的神经保护剂，作者推测促红细胞生成素能提升亚低温治疗新生儿缺氧缺血性脑病的效果。试验将41例中重度缺氧缺血性脑病患儿随机分为对照组（n = 20）和促红细胞生成素治疗组（n=21），分别采取持续72h 的低温治疗单独或联合连续10d静脉注射200 IU/kg促红细胞生成素治疗。结果显示，与单独使用低温治疗患者相比，促红细胞生成素联合低温治疗的患者治疗后8，12d时血清中脑损伤的标志物tau蛋白水平较低，新生儿行为神经评分较高，但2组随访9个月时神经发育结果情况接近。表明与单独使用低温治疗相比，促红细胞生成素联合低温更为明显地降低缺氧缺血性脑病新生儿血清tau蛋白的水平，改善患儿早期神经行为，但不影响远期神经发育结果。

orcid:0000-0002-0224-6683(Lian-xiang Li)

关键词: 神经再生, 促红细胞生成素, 低温, 缺氧缺血性脑病, 新生儿, tau蛋白, 生物标志物, 预后, 神经保护

Abstract:

Although hypothermia therapy is effective to treat neonatal hypoxic-ischemic encephalopathy, many neonatal patients die or suffer from severe neurological dysfunction. Erythropoietin is considered one of the most promising neuroprotective agents. We hypothesized that erythropoietin combined with hypothermia will improve efficacy of neonatal hypoxic-ischemic encephalopathy treatment. In this study, 41 neonates with moderate/severe hypoxic-ischemic encephalopathy were randomly divided into a control group (hypothermia alone for 72 hours, n = 20) and erythropoietin group (hypothermia + erythropoietin 200 IU/kg for 10 days, n = 21). Our results show that compared with the control group, serum tau protein levels were lower and neonatal behavioral neurological assessment scores higher in the erythropoietin group at 8 and 12 days. However, neurodevelopmental outcome was similar between the two groups at 9 months of age. These findings suggest that erythropoietin combined with hypothermia reduces serum tau protein levels and improves neonatal behavioral neurology outcome but does not affect long-term neurodevelopmental outcome.

Key words: nerve regeneration, erythropoietin, hypothermia, hypoxic-ischemic encephalopathy, neonate, tau protein, biomarkers, prognosis, neuroprotection, neural regeneration