摘要
目的:观察新生儿缺氧缺血性脑病(HIE)血清血管内皮生长因子(VEGF)、脑代谢物水平的动态变化,以及VEGF与脑代谢物的相关性,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:选取确诊轻度HIE、中度HIE、重度HIE足月新生儿各15例作为观察组,15例无窒息、无神经系统疾病的足月新生儿为对照组;所有实验对象于生后24h、第3天、第7天、第10天测血清VEGF,10d内行氢质子MR波谱(1H-MRS)扫描,记录各代谢产物波峰下面积。结果:1观察组VEGF在生后24h即升高,以后逐渐下降;在24h、3d、7d时,对照组与观察组、轻度HIE组与中度HIE组、中度HIE组与重度HIE组血清VEGF水平有显著差异(P<0.05);第10天时,对照组与HIE组血清VEGF水平差异无统计学意义(P>0.05)。2对照组与HIE各组及HIE各组间的氮-乙酰天门冬氨酸(NAA)/肌酸(Cr)、NAA/胆碱(Cho)、乳酸(Lac)/Cr两两比较,差异有统计学意义(P<0.05),对照组与HIE组Cho/Cr比较,差异无统计学意义。3血清VEGF水平与NAA呈负相关,血浆VEGF水平与Lac呈正相关。结论:VEGF可能作为新生儿HIE早期诊断、分度、预后推测、简单易行且易推广的一种重要指标。
Objective： To observe the dynamic changes of vascular endothelial growth factor（VEGF） in serum, brain metabolites, and their relationship in hypoxic-ischemic encephalopathy （HIE） new- borns. Methods： Fifteen full-term newborns were selected respectively from mild, moderate, se- vere HIE neonates as experimental group, and 15 cases without choking and nervous system dis- eases as the controls. Serum VEGF was assayed at the end of 24 hours,3 days,7 days,10 days of- ter birth. Adept ~H-MRS scanning was conducted within 10 days after birth and the area under each metabolite peaks were recorded. Results： ①VEGF in the experimental group had a rise 24 hours after birth and then descended. Within 24 h, 3 d, 7 d, there were significant differences in VEGF by comparision beween the control group and each of the mild HIE group and moderate HIE group, the moderate HIE group and severe HIE group （P〈0.05）. There was no significant difference in serum VEGF level in the control group and experimental group 10 days after birth（P 〉0.05）. ②There was a significant difference in the ratio of NAA/Cr, NAA/Cho, and Lac/Cr between HIE group and control group（P〈0.05）, and there was a significant difference in the ratio of NAA/Cr, NAA/Cho, and Lac/Cr between different HIE groups（P〈0.05）. There was no significant difference in the ratio of Cho/Cr between HIE group and control group（P〉0.05）. ③VEGF was negatively related to the NAA and positively correlated to the Lac. Conclusion： VEGF may be used as the simple and significant index in the diagnosis, grading and prognostic estimation of HIE.
出处
《武汉大学学报（医学版）》
CAS
2015年第5期772-775,共4页
Medical Journal of Wuhan University
关键词
缺氧缺血脑病
新生儿
血管内皮生长因子
磁共振成像
磁共振波谱
Hypoxic-ischemic Encephalopathy
Newborn
Vascular Endothelial Growth Factor
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy
