新生儿缺氧缺血性脑病与血管内皮生长因子水平的临床观察

目的观察新生儿缺血缺氧性脑病(HIE)血浆和脑脊液中血管内皮生长因子(Vascular endothelial growthfactor,VEGF)与神经元特异性烯醇化酶(Neuron-specific enolase NSE)含量的动态变化,探索VEGF与HIE早期诊断、预后判断及有关机理的临床相关性。方法选择确诊HIE足月新生儿38例(轻度15例,中度12例,重度11例)作为观察组,12例无神经系统疾病的足月新生儿为对照组;分别于生后24h、7、10天测血浆VEGF和NSE,于生后24h测脑脊液VEGF和NSE,分析VEGF与NSE、疾病程度相关性及意义。结果观察组VEGF与NSE在生后24h即升高,与对照组比较有显著差异(P<0.01);以后逐渐下降,与生后7天比较有显著差异(P<0.05);VEGF与NSE、疾病程度有相关性。结论血管内皮生长因子(VEGF)可能作为新生儿缺血缺氧性脑病(HIE)诊断、疾病严重程度和预后判断的一种重要指标。

Clinic study between the level of vascular endothelial growth factor and newborns with hypoxic-ischemic encephalopathy

Objective: To observe the dynamic changes of vascular endothelial growth factor(VEGF) and neuron-specific enolase(NSE) in cerebrospinal fluid and plasma with hypoxic-ischemic encephalopathy and investigate early diagnosis,prognostic estimation as well as mechanism of clinic correlation.Methods: 38 newborns with HIE were chosen as experimental group(15cases were mild,12 moderate,11 severe).13 neonates without nervous system diseases were used as controls.They were examined plasma VEGF and NSE in 24hours,7days,10days after birth respectively.VEGF and NSE of cerebrospinal fluid were measured in 24hours after birth.The value and correlation among VEGF,NSE and grade of HIE were analyzed.Results: VEGF and NSE in the experimental group in 24hours after birth were higher than ones in the controls immediately(P<0.01),and then descended.When they were born after 7days,VEGF and NSE in the experimental group comparing with ones in the controls had significant difference(P<0.05).It had a correlation among VEGF and NSE,grade of HIE.Conclusion: VEGF may be used as the significant index in the diagnosis,prognostic estimation and grade of HIE.