目的 系統(tǒng)評價鼠神經(jīng)生長因子聯(lián)合神經(jīng)節(jié)苷脂治療新生兒缺氧缺血性腦?。℉IE）的療效和安全性。方法 計算機檢索中國期刊全文數(shù)據(jù)庫（CNKI）、維普中文科技期刊全文數(shù)據(jù)庫（VIP）、中國生物醫(yī)學(xué)文獻數(shù)據(jù)庫（CBM）、萬方數(shù)據(jù)庫、PubMed、EMbase等數(shù)據(jù)庫，收集鼠神經(jīng)生長因子聯(lián)合神經(jīng)節(jié)苷脂治療新生兒HIE的隨機對照研究，提取資料并評價質(zhì)量后，采用RevMan 5.1軟件進行Meta-分析。結(jié)果 共納入8篇文獻，716例患兒；Meta-分析結(jié)果顯示，與單用神經(jīng)節(jié)苷脂比較，鼠神經(jīng)生長因子聯(lián)合神經(jīng)節(jié)苷脂：顯著提高臨床有效率[RR=1.32，95%CI（1.22，1.43），P<0.01]和NBNA評分[MD=4.00，95%CI（3.54，4.46），P<0.01]；顯著縮短意識恢復(fù)時間[MD=-1.74，95%CI（-2.44，-1.04），P<0.01]、驚厥消失時間[MD=-1.47，95%CI（-1.88，-1.06），P<0.01]、肌張力恢復(fù)時間[MD=-2.73，95%CI（-3.19，-2.28），P<0.01]和反射恢復(fù)時間[MD=-2.57，95%CI（-3.32，-1.82），P<0.01]；顯著降低血清神經(jīng)元特異性烯醇化酶（NSE）[MD=-5.04，95%CI（-6.26，-3.82），P<0.01]和血管內(nèi)皮生長因子（VEGF）[MD=-29.63，95%CI（-33.11，-26.16），P<0.01]；顯著提高智力發(fā)育指數(shù)（MDI）[MD=8.87，95%CI（7.92，9.82），P<0.01]和心理運動發(fā)育指數(shù)（PDI）[MD=9.89，95%CI（8.52，11.27），P<0.01]。結(jié)論 鼠神經(jīng)生長因子聯(lián)合神經(jīng)節(jié)苷脂對新生兒HIE受損腦神經(jīng)元及神經(jīng)膠質(zhì)細胞神經(jīng)元功能具有協(xié)同修復(fù)作用，與協(xié)同降低血清NSE和VEGF水平有關(guān)。

Objective To evaluate the efficacy and safety of mouse nerve growth factor (MNGF) and ganglioside in treatment of neonatal hypoxic-ischemic encephalopathy (HIE). Methods Randomized controlled trials (RCT) and cohort studies about MNGF combined with ganglioside in the treatment of neonatal HIE were retrieved from PubMed, Embase, CNKI, VIP, CBM and Wangfang databases. Meta-analysis was performed by using Rev Man 5.3 software after data extraction and quality evaluation. Results Totally eight RCTs and 716 patients were included. Meta-analysis showed that, compared with ganglioside alone, MNGF combined with ganglioside significantly improved the clinical efficiency[RR=1.32, 95%CI(1.22,1.43), P < 0.01] and NBNA scores[MD=4.00, 95%CI (3.54, 4.46), P < 0.01] after treatment; It significant reduced the conscious recovery time[MD=-1.74, 95%CI (-2.44, -1.04), P < 0.01], convulsant disappearance time[MD=-1.47, 95%CI (-1.88, -1.06), P < 0.01], muscle tone recovery time[MD=-2.73, 95%CI (-3.19, -2.28), P < 0.01], and reflex recovery time[MD=-2.57, 95%CI (-3.32, -1.82), P < 0.01]; It significantly lowered NSE levels[MD=-5.04, 95%CI (-6.26, -3.82), P < 0.01] and VEGF levels[MD=-29.63,95%CI (-33.11, -26.16), P < 0.01]; It significantly increased MDI levels (MD=8.87, 95%CI (7.92, 9.82), P < 0.01] and PDI levels[MD=9.89, 95%CI (8.52, 11.27), P < 0.01]. Conclusion MNGF combined with gangliosides have a synergistic recovery effect on the neuronal function of neurons and glial cells in neonates with HIE, which is related to the synergistic reduction of serum NSE and VEGF levels.