不同临床分度HIE新生儿血清sICAM-1水平动态变化

目的探讨轻、中、重度缺氧缺血性脑病(HIE)新生儿疾病极期和恢复期初血清可溶性细胞间黏附分子-1(sICAM-1)水平的动态变化及意义。方法对照组正常足月新生儿脐血17例,轻(13例)、中(14例)、重度(9例)HIE患儿组共36例,对所有患儿疾病极期、恢复期初血清sICAM-1水平进行双抗体夹心酶联免疫(ELISA)法检测。统计学处理采用方差分析、q检验及t检验。结果轻、中、重度HIE组患儿疾病极期血清sICAM-1水平显著升高,但3组升高的水平差异显著(P<0.001、0.01)。3组恢复期初血清sICAM-1水平均较极期显著下降(P<0.001),但均未降至对照组水平(P<0.01);且3组之间仍有差异,中、重度之间的差异已无意义(P>0.05),而中、重度与轻度间的差异显著(P<0.01)。结论HIE疾病极期血清sICMA-1水平急剧升高的程度与脑损伤程度密切相关。临床动态监测HIE患儿血清sICAM-1有助于判断其病情轻重和预后。

The changes of sICAM-1 concentrations in serum of neonates with hypoxic ischemic encephalopathy

Object To study the changes of the soluble intercelluar adhesion molecule-1(sICAM-1) in the serum at the critical stage and the beginning of convalescent stage of mild, moderate and sever group of neonates suffering from hypoxic ischemic encephalopathy (HIE), and the significance in the change of the serum sICAM-1 in HIE. Methods According to the state of illness, 36 cases were divided into three groups, which were mild group (13 cases), moderate group (14 cases) and severe group ( 9 cases). The control group is 17 normal neonates. The sICAM-1 concentrations in the serum were detected with enzyme-linked immunosorbent assay(ELISA)at the critical stage and the beginning of convalescent stage in 36 cases of HIE neonates and 17 normal neonates. The data are analyzed with analysis of variance, Newman-Keuls q test and Dunnett t test.Results The sICAM-1 concentrations in the serum at critical stage of mild, moderate and severe group were all significantly higher than that of the control group(P<0.001) .The differences of three groups were significant(P<0.001、0.01). The sICAM-1 concentrations in the serum of three groups at the beginning of convalescent stage were all lower than those at the critical stage (P<0.001), but higher than that of control group(P<0.01). The difference between moderate and severe group was not significant (P>0.05). But the differences between mild and moderate or severe group were all significant (P<0.01). Conclusion The sICAM-1 concentrations rise sharply at the critical stage of HIE. They are closely related to degree of brain damage. It is help to judge the state of the illness and the prognosis that we observe the serum sICAM-1 concentrations in the neonates with HIE