A randomized controlled trial on the use of magnesium sulfate and melatonin in neonatal hypoxic ischemic encephalopathy.
A randomized controlled trial on the use of magnesium sulfate and melatonin in neonatal hypoxic ischemic encephalopathy.
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DOI：
10.3233/npm-181830
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发表时间：
2019-01-01
影响因子：
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通讯作者：
Soliman, N A
中科院分区：
文献类型：
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作者：
El Farargy, M S;Soliman, N A
背景：出生窒息是新生儿发病和死亡的主要原因，尤其是在发展中国家。窒息引起的缺氧缺血性脑病（HIE）可以通过多种补救措施得到改善，但目前完全康复尚不可行。这项试验的目的是针对正在接受褪黑激素治疗的 HIE 婴儿，评估硫酸镁 (MgSO4) 对 S100-B（脑损伤标志物）表达的附加影响。 方法：本研究是一项针对中度 HIE（Sarnat II 级）新生儿的随机对照试验。婴儿被随机分为 2 组；第1组接受MgSO4和褪黑激素；第 2 组仅接受褪黑激素治疗。在基线以及治疗第 2 天和第 6 天测量 S100-B 的血清浓度。 结果：该研究包括 60 名新生儿，其中第 1 组有 30 名婴儿，第 2 组有 30 名婴儿。入组时第 1 组和第 2 组之间的 S100-B 没有差异（中位数 = 13.5 vs 13.2，p = 0.381）。然而，第 1 组在第 2 天时的 S100-B 浓度较低（中位数 = 8 vs 12，p = 0.001）和第 6 天（中位数 = 3 vs 10.5，p = 3）
BACKGROUND: Birth asphyxia is a leading case of neonatal morbidity and mortality especially in developing countries. Hypoxic-ischemic encephalopathy (HIE) attributed to asphyxia can be ameliorated with several remedies, although full recovery is currently not feasible. The aim of this trial on infants with HIE who are receiving melatonin therapy, is to assess the added effect of magnesium sulfate (MgSO4) on the expression of S100-B, a marker of brain injury.METHODS: This study is a randomized controlled trial on neonates with moderate HIE (Sarnat grade II). Infants were randomized into 2 groups; group1 who received MgSO4 and melatonin; and group 2 who received melatonin only. Serum concentrations of S100-B were measured at baseline, and at days 2 and 6 of therapy.RESULTS: The study included 60 neonates of them 30 infants in group 1 and 30 infants in group 2. S100-B did not differ between groups 1 and 2 at enrollment (median = 13.5 vs 13.2, p = 0.381). However, group 1 had lower concentrations of S100-B at 2 days (median = 8 vs 12, p = 0.001) and at 6 days (median = 3 vs 10.5, p