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目的:探讨苯巴比妥(PB)治疗新生儿缺氧缺血性脑病(HIE)的疗效及其有效血药浓度。方法:130例HIE患儿随机分为治疗组67例和对照组63例,分别采用常规治疗和PB负荷治疗。应用荧光偏振免疫法监测治疗组患儿PB血药浓度。结果:治疗组患儿有44例(65.67%)PB达到15～40μg·ml~(-1)的有效浓度范围,临床有效率达86.36%(39/44),其中PB血药浓度为25～40μg·ml~(-1)患儿的有效率达96.30%(26/27)。治疗组总有效率(85.1%)高于对照组(66.7%)(P<0.05)。结论:PB负荷治疗HIE方案基本合理,效果优于常规治疗。PB血药浓度25～40μg·ml~(-1)时治疗HIE疗效最佳。
Objective: To investigate the curative effect and effective plasma concentration of phenobarbital (PB) in neonates with hypoxic-ischemic encephalopathy (HIE). Methods: A total of 130 children with HIE were randomly divided into treatment group (n = 67) and control group (n = 63), which were treated with routine treatment and PB load respectively. Fluorescence polarization immunoassay was used to monitor the blood concentration of PB in the treatment group. Results: In the treatment group, 44 (65.67%) PB patients reached the effective concentration range of 15 ~ 40μg · ml ~ (-1), and the clinical effective rate was 86.36% (39/44). The PB blood concentration was 25 ~ The effective rate of 40μg · ml ~ (-1) children was 96.30% (26/27). The total effective rate (85.1%) in the treatment group was higher than that in the control group (66.7%) (P <0.05). Conclusion: The treatment of HIE with PB load is basically reasonable and the effect is better than that of routine treatment. The best therapeutic effect of HIE when PB blood concentration is 25 ~ 40μg · ml ~ (-1).