血清胶质纤维酸性蛋白、胰岛素样生长因子与新生儿缺氧缺血性脑病的相关性研究  

Relationship between serum glial fibrillary acidic protein,insulin-like growth factor and neonatal hypoxic-ischemic encephalopathy

作　　者：孙颖慧 SUN Yinghui(Deparment of Paediatrics,Tiantai People’sHospital,Tiantai 317200,China)

机构地区：[1]天台县人民医院儿科,浙江天台317200

出　　处：《全科医学临床与教育》2019年第2期117-119,共3页Clinical Education of General Practice

摘　　要：目的探讨血清胶质纤维酸性蛋白(GFAP)、胰岛素样生长因子(IGF-1)与新生儿缺氧缺血性脑病(HIE)的相关性。方法选取82例HIE患儿作为研究对象,根据新生儿的意识状态、肌张力和原始反射等临床表现及CT影像学结果分为轻度HIE组、中度HIE组和重度HIE组。同时选取经体检后各检查指标均正常的健康足月新生儿30例作为对照组,比较四组HIE新生儿行为神经评分(NBNA评分)、血清GFAP和IGF-1水平的变化,并分析血清GFAP和IGF-1水平与NBNA评分的相关性。结果轻度HIE组患儿的NBNA评分和血清IGF-1水平明显低于对照组,血清GFAP水平明显高于对照组(t分别=3.65、5.31、4.57,P均<0.05),中度HIE组患儿的NBNA评分和血清IGF-1水平明显低于轻度组,血清GFAP水平明显高于轻度组(t分别=5.91、5.23、4.06,P均<0.05),重度HIE组患儿的NBNA评分和血清IGF-1水平明显低于中度组,血清GFAP水平明显高于中度组(t分别=7.12、4.35、6.85,P均<0.05)。血清GFAP水平与NBNA评分呈正相关(r=0.54,P<0.05),IGF-1与NBNA评分呈负相关(r=-0.61,P<0.05)。结论血清GFAP和IGF-1水平能反映HIE患儿的病情,对HIE的早期诊断、病情严重程度的判断具有重要作用。Objective To study the relationship between serum glial fibrillary acidic protein,insulin-like growth factor and neonatal hypoxic-ischemic encephalopathy.Methods A total of 82 neonates with hypoxic-ischemic encephalopathy(HIE)were selected and divided into mild HIE group,moderate HIE group and severe HIE group according to the clinical manifestations of neonatal consciousness,muscle tension and primitive reflex and CT imaging results.At the same time,30 healthy full-term newborns were selected as control group.The NBNA,serum GFAP and IGF-1 levels among four groups were compared,and the correlations between the serum GFAP,IGF-1 level and NBNA score were analyzed.Results The NBNA score and the level of serum IGF-1 in mild HIE group were significantly lower than those in control group(t=3.65,5.31,P<0.05),while the level of serum GFAP was significantly higher than that in control group(t=4.57,P<0.05).The NBNA score and level of serum IGF-1 in the moderate HIE group were significantly lower than those in the mild group,while the level of serum GFAP was significantly higher than that in the mild group(t=5.91,5.23,4.06,P<0.05).The NBNA score and the level of serum IGF-1 in the severe HIE group were significantly lower than those in the moderate group,and the level of serum GFAP was significantly higher than that in the moderate group(t=7.12,4.35,6.85,P<0.05).The serum GFAP level was positively related to NBNA score(r=0.54,P<0.05),and IGF-1 was negatively correlated to NBNA score(r=-0.61,P<0.05).Conclusions The serum levels of GFAP and IGF-1 can reflect the condition of children with HIE and play an important role in the early diagnosis of HIE and the judgement of severity of the disease.

关 键 词：血清胶质纤维酸性蛋白 胰岛素样生长因子 新生儿缺氧缺血性脑病 新生儿行为神经评分 

分 类 号：R722.1[医药卫生—儿科]