血管内皮生长因子、脑型肌酸激酶同工酶的动态检测在新生儿缺氧缺血性脑病中的意义

目的:探讨血管内皮生长因子（VEGF）、脑型肌酸激酶同工酶（CK-BB）动态检测在新生儿缺氧缺血性脑病（HIE）中的临床价值。方法:选取HIE患儿（轻度33例、中度27例、重度24例） 84例（HIE组），均常规胞二磷胆碱及1，6-二磷酸果糖静脉滴注治疗，另选取同期正常足月新生儿52名（对照组），分别于出生后24 h、72 h和7 d动态检测2组VEGF、CK-BB水平。结果:出生后24 h和72 h，HIE不同程度组患儿VEGF水平均为重度组 > 中度组 > 轻度组，且均明显高于对照组（P < 0.01）；出生后7 d，HIE各组与对照组VEGF水平差异均无统计学意义（P > 0.05）。出生后24 h、72 h和7 d，HIE不同程度组患儿CK-BB水平均为重度组 > 中度组 > 轻度组；出生后24 h和72 h，HIE各组CK-BB水平均明显高于对照组（P < 0.01）；出生后7 d，重度、中度HIE组CK-BB水平均明显高于对照组（P < 0.01），HIE轻度组与对照组差异无统计学意义（P > 0.05）。结论:HIE患儿VEGF、CK-BB表达水平明显升高，动态检测有助于判断HIE患儿脑损伤程度，对于HIE的诊断、治疗及预后有积极意义。

Clinical value of the dynamic detection of vascular endothelial growth factor and brain specific isoenzyme of creatine kinase in neonates with hypoxic ischemic encephalopathy

Objective: To investigate the clinical value of the dynamic detection of vascular endothelial growth factor(VEGF) and brain specific isoenzyme of creatine kinase(CK-BB) in neonates with hypoxic ischemic encephalopathy(HIE).Methods: Eighty-four neonates with HIE(HIE group),which included 33 mild cases,27 moderate cases and 24 severe cases,were intravenously injected with citicoline and 1,6 fructose diphosphate.Fifty-two normal newborns were set as the control group.The levels of VEGF and CK-BB in two groups were detected after 24 h,72 h and 7 d of birth.Results: After 24 h and 72 h of birth,the levels of VEGF in severe HIE,moderate HIE and mild HIE were gradual decreasing,which was significantly higher than that in control group.After 7 d of birth,the differences of the levels of VEGF between two groups were not statistically significant(P > 0.05).After 24 h,72 h and 7 d of birth,the levels of CK-BB in severe HIE,moderate HIE and mild HIE were gradual decreasing,the levels of CK-BB in HIE group were significantly higher than that in control group after 24 h and 72 h of birth(P < 0.01).After 7 d of birth,the levels of CK-BB in moderate and severe HIE patients were significantly higher than that in control group(P < 0.01),and the difference of the level of CK-BB between the mild patients and control group was not statistically significant(P > 0.05).Conclusions: The levels of VEGF and CK-BB in neonates with HIE increase significantly,the dynamic detection of which can help to determine the degree of brain injury in neonates with HIE,and has positive value in the diagnosis,treatment and prognosis of HIE.