内源性激活素A水平与新生儿窒息及其预后的关系

山东大学学报(医学版)

内源性激活素A水平与新生儿窒息及其预后的关系

罗焕华，郑媛，安丽

山东大学附属济南市中心医院小儿内科，济南 250013

收稿日期:2008-05-24 修回日期:1900-01-01 出版日期:2008-11-16 发布日期:2008-11-16
通讯作者: 安丽

Relationship between activin A and hypoxic ischemic encephalopathy in neonate with asphyxiation

LUO Huan-hua, ZHENG Yuan, AN Li

Department of Pediatrics, Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, China

Received:2008-05-24 Revised:1900-01-01 Online:2008-11-16 Published:2008-11-16
Contact: AN Li

摘要/Abstract

摘要： 目的研究内源性激活素A（ACT A）的水平变化及其与新生儿窒息后缺氧缺血性脑病（HIE）的发生、严重程度以及预后的相关性。方法用ELISA方法动态监测58例窒息足月新生儿（轻、重度窒息39、19例）和30例正常足月新生儿血清ACT A及成纤维细胞生长因子（FGF）、肿瘤坏死因子-α(TNF-α)的浓度（脐血、7d），同时观察意识状态、肌张力、原始反射、有无惊厥及瞳孔改变、呼吸、心率、囟门张力等临床指标，结合颅脑CT进行临床诊断与分度。结果窒息新生儿脐血血清ACT A,FGF和TNF-α水平明显升高（P均＜0.01）。ACT A水平与生后1min Apgar评分呈负相关（r＝-0.948, P＜0.01）。生后7?d窒息组患儿血清ACT A、FGF水平仍高于对照组(P均＜0.01)， TNF-α水平差异无统计学意义(P＞0.05)。各项临床指标按照新生儿HIE的临床分度标准量化赋分，与血清ACT A水平进行相关性分析，结果显示ACT A水平与HIE的严重程度呈正相关（r＝0.962，P＜0.01）。结论内源性ACT A参与窒息后新生儿HIE的发病过程,动态检测内源性ACT A水平对判断窒息所致新生儿HIE的严重程度及估计预后可能具有重要价值。

关键词: 脑, 细胞因子类, 新生儿, 缺氧缺血, 窒息, 激活素类

Abstract: To explore the changes of endogenous activin A (ACT A) in neonates with asphyxia and the relation between ACT A and hypoxicischemic encephalopathy (HIE). MethodsSerum ACT A, FGF and TNF-α were determined at postnatal 1 day (P1, cord blood) and postnatal 7 day (P7) in 58 term infants with asphyxia and 30 normal controls by enzyme-linked immunosorbent assay (ELISA). Clinical grading was performed based upon related clinical data. ResultsConcentrations of serum ACT A, FGF and TNF-α were much higher in neonates with asphyxia than in controls at P1 （P＜0.01）. There was a negative correlation between the level of serum ACT A and Apgar scores at 1 minute after birth（r＝-0.948, P＜0.01）. Also concentrations of serum ACT A and FGF were higher in neonates with asphyxia than in controls at P7 (P＜0.01). However, concentration of serum TNF-α was not significantly different between neonates with asphyxia and normal controls（P＞0.05). Based on clinical grading of HIE, related clinical data was scored in neonates with asphyxia. Correlation analysis between the level of serum ACT A and clinical scores showed that there was a positive correlation between the level of serum ACT A and severity of HIE（r＝0.962，P＜0.01）. ConclusionEndogenous ACT A plays a role in the pathogenesis of HIE. Dynamic detection of serum ACT A may be helpful to evaluate the severity and prognosis of HIE.

Key words: Activins, Asphyxia neonatorum, Hypoxiaischemia, brain, Cytokines

中图分类号:

R722.12

罗焕华,郑媛,安丽. 内源性激活素A水平与新生儿窒息及其预后的关系[J]. 山东大学学报(医学版), 2008, 46(11): 1057-1059.

LUO Huan-hua,ZHENG Yuan,AN Li. Relationship between activin A and hypoxic ischemic encephalopathy in neonate with asphyxiation[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2008, 46(11): 1057-1059.

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