新生儿缺氧缺血性脑病患儿血管内皮生长因子、血浆内皮素-1水平变化及临床意义

目的:探讨血管内皮生长因子(VEGF)、血浆内皮素-1(ET-1)在新生儿缺氧缺血性脑病(HIE)的动态变化及临床意义。方法:分别采用ELISA法及放射免疫法(RIA),动态检测54例HIE患儿与25例对照组新生儿VEGF、ET-1水平;同时对HIE患儿生后7～10天进行新生儿行为神经评分(NBNA)。结果:①轻、中、重度HIE患儿VEGF水平均明显高于对照组(P<0.01),且恢复期水平较急性期显著升高,以重度HIE组升高明显(P<0.01)。②轻、中、重度HIE患儿血浆ET-1水平均明显高于对照组(P<0.01),轻、中度HIE患儿恢复期血浆ET-1水平降至正常,而重度HIE组血浆ET-1水平仍高于对照组(P<0.01)。③NBNA评分<35分组其血浆VEGF、ET-1水平显著高于评分>35分组(P<0.01)。结论:动态监测血浆VEGF、ET-1水平对临床判断HIE严重程度及预后具有一定的指导意义。

Changes and clinical significance of vascular endothelial growth factor and plasma endothelin-1 in children with neonatal hypoxic-ischemic encephalopathy

Objective:To explore the dynamic changes and clinical significance of vascular endothelial growth factor (VEGF) and plasma endothelin-1 (ET-1) in children with neonatal hypoxic-ischemic encephalopathy (HIE).Methods:The levels of VEGF and ET-1 in 54 HIE cases and 25 healthy neonates were detected by ELISA and RIA.The NBNA grade was conducted on the HIE infants in 7~10 days after birth.Results:①The levels of VEGF in HIE group (mild,middle and severe) were higher than that in control group (P<0.01),and the level of VEGF was higher in recovery phase than that in acute stage,especially in the severe group (P<0.01).②The levels of ET-1 in HIE group (mild,middle and severe) were higher than that in control group (P<0.01).The level of ET-1 in recovery phase in mild group and middle group descended to the normal level and the ET-1 level in severe group was still higher than that in control group (P<0.01).③The levels of VEGF and ET-1 in the group of grade less than 35 were higher than those in the group of grade more than 35 (P<0.01).Conclusion:Dynamic monitoring of VEGF and ET-1 levels can be used to assess the severe degree and prognosis in children with HIE.