目的观察选择性头部亚低温疗法联合鼠神经生长因子治疗新生儿缺氧缺血性脑病(HIE)的疗效及其对氧化应激水平和炎症因子表达的影响。方法采用随机数字表法将108例HIE患儿分为观察组和对照组,每组各54例。对照组患儿给予降颅压、抗惊厥等常规治疗,同时给予选择性头部亚低温疗法。观察组在对照组治疗基础上给予鼠神经生长因子30μg,肌肉注射,1次/d,连续应用2周为1个疗程。观察两组患儿临床症状改善情况、行为神经评分(NBNA)、心理运动发育指数(PDI)和智力发育指数(MDI)、氧化应激指标、炎性细胞因子及神经相关因子水平变化,观察不良反应发生情况。结果观察组患儿意识、反射、肌张力、惊厥等临床症状的改善时间显著短于对照组(P<0.05)。经治疗后2周,两组患儿NBNA评分、MDI指数及PDI指数均较治疗前显著提高(P<0.05),且治疗后观察组各项评分显著高于对照组(P<0.05)。两组患儿超氧化物歧化酶(SOD)和谷胱甘肽过氧化物酶(GSH-Px)水平均较治疗前显著增高,丙二醛(MDA)和一氧化氮(NO)水平均显著降低(P<0.05)。其中,观察组治疗后SOD和GSH-Px水平显著高于对照组,MDA和NO水平均显著低于对照组治疗后(P<0.05)。治疗后2周,两组患儿各项炎性细胞因子水平均较治疗前显著降低(P<0.05)。且观察组治疗后各项炎性细胞因子水平显著低于对照组治疗后(P<0.05)。两组患儿神经元特异性烯醇化酶(NSE)水平较治疗前显著降低(P<0.05)。观察组治疗后NSE水平显著低于对照组治疗后(P<0.05)。观察组神经营养因子(NTF)水平较治疗前显著增高(P<0.05)。对照组NTF水平较治疗前略增高(P>0.05)。两组患儿治疗过程中均无严重不良反应发生。结论选择性头部亚低温疗法联合鼠神经生长因子治疗HIE的疗效确切,可显著改善患儿临床症状,降低脑组织氧化应激水平,减轻神经炎性损伤,优于单纯选择性头部亚低温疗法。 Objective To observe the curative effect of selective head moxibustion combined with murine nerve growth factor (NGF) on neonatal hypoxic-ischemic encephalopathy (HIE) and its effect on the level of oxidative stress and the expression of inflammatory cytokines. Methods 108 cases of HIE were divided into observation group and control group by random number table method, each group had 54 cases. Children in the control group were given conventional therapy such as intracranial pressure reduction and anticonvulsant, while selective head mild hypothermia was given. The observation group was given 30 μg of nerve growth factor (nGF) on the basis of the control group, intramuscularly and once a day for 2 weeks. The improvement of clinical symptoms, NBNA, PDI and MDI, oxidative stress, inflammatory cytokines and nerve related factors were observed in two groups. The observation was poor Reaction occurred. Results The improvement time of clinical symptoms such as consciousness, reflex, muscle tone and convulsion in observation group was significantly shorter than that in control group (P <0.05). After 2 weeks of treatment, NBNA score, MDI index and PDI index in both groups were significantly higher than those before treatment (P <0.05). After treatment, the scores in the observation group were significantly higher than those in the control group (P <0.05). The levels of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in both groups were significantly higher than those before treatment, and the levels of malondialdehyde (MDA) and nitric oxide (NO) Decreased (P <0.05). Among them, the levels of SOD and GSH-Px in the observation group were significantly higher than those in the control group, and the levels of MDA and NO in the observation group were significantly lower than those in the control group after treatment (P <0.05). Two weeks after treatment, the levels of inflammatory cytokines in both groups were significantly lower than those before treatment (P <0.05). The levels of inflammatory cytokines in the observation group were significantly lower than those in the control group after treatment (P <0.05). The levels of neuron-specific enolase (NSE) in both groups were significantly lower than those before treatment (P <0.05). The NSE level in observation group was significantly lower than that in control group after treatment (P <0.05). The level of neurotrophic factor (NTF) in observation group was significantly higher than that before treatment (P <0.05). The level of NTF in control group was slightly higher than that before treatment (P> 0.05). Two groups of children with no serious adverse reactions occurred during treatment. Conclusion The selective head hypothermia therapy combined with mouse nerve growth factor in the treatment of HIE is effective and can significantly improve the clinical symptoms of children, reduce the level of oxidative stress in brain tissue, reduce neuronal injury, better than the selective head mild hypothermia therapy.