A Clincical obserration of hyperbaric oxygen combined with recombinant human erythropoietin in neonates with hypoxic-ischemic encephalopathy

Abstract

Objective To investigate the efficacy of hyperbaric oxygen (HBO) combined with recombinant human erythropoietin injection on neonatal hypoxic-ischemic encephalopathy (HIE), and the effects on the expression levels of cysteine aspartic protease-3 (caspase-3) and endogenous activin A (ACT A). Methods eventy-six child patients with HIE admitted to the Department of Pediatrics of the hospital from October 2015 to May 2017 were enrolled for the study, and were randomly divided into the observation group and the control group, each consisting of 38 patients. The patients in the control group received HBO therapy on the basis of conventional treatment, while the patients in the observation group had human erythropoietin injection in addition to the treatment received by the control group. After 10 days of treatment, treatment efficacy was evaluated for the 2 groups. After 5 and 10 days of treatment, the neonatal behavioral neurological assessment (NBNA) scores were evaluated, and nerve reflex recovery time and conscious recovery time for the patients of the 2 groups were recorded. The levels of serum caspase-3 and ACT A in the patients of the 2 groups were measured by enzyme-linked immunosorbent assay (ELISA), and adverse reactions of the two groups were recorded as well. Results Total efficacy rate for the observation group (89.47%)was significantly higher than that for the control group (71.05%)(P<0.05), After 5 and 10 days of treatment, the NBNA scores of the 2 groups were all significantly higher than those before treatment and the NBNA scores of the observation group were significantly higher than those before treatment, and the NBNA scores of the observation group were also obviously higher than those of the control group (P<0.05 or P<0.01). After treatment, the nerve reflex recovery time and conscious recovery time of the observation group were all shorter than those of the control group (P<0.05). After 5 days of treatment, the caspase-3 levels of the two groups were significantly higher than those before treatment, and that of the observation group was obviously lower than that of the control group(P<0.05). However, after 10 days of treatment, the caspase-3 levels in the 2 groups all decreased markedly, as compared with those after 5 days of treatment, and. that of the observation group was obviously lower than that of the control group(P<0.05). Conclusion HBO combined with recombinant human erythropoietin injection was superior to simple HBO therapy in the treatment of HIE, and could down-regulate the expression levels of Caspase-3 and ACT A, inhibit cell apoptosis, promote cell repair and ultimately lessen nerve damage. Key words: Hyperbaric oxygen; Recombinant human erythropoietin; Neonatal hypoxic-ischemic encephalopathy; Caspase-3; Endogenous activin A(ACTA)