新生儿缺氧缺血性脑病肌酸磷酸激酶心型同工酶、血清血管内皮生长因子临床探究.docVIP

新生儿缺氧缺血性脑病肌酸磷酸激酶心型同工酶、血清血管内皮生长因子临床探究[摘要] 目的：探讨新生儿缺氧缺血性脑病(HIE)时肌酸磷酸激酶心型同工酶(CK-MB) 、血清血管内皮生长因子(VEGF)的动态变化及其意义。方法：以51例HIE的足月新生儿为HIE组，50例足月正常健康新生儿为对照组。分别在出生后24 h、72 h、7 d采集空腹静脉血，检测血清中总CK-MB及VEGF。 结果：HIE组血清CK-MB及VEGF均在24 h表达为最高峰，与对照组比较差异有显著性(P0.05)。 结论：CK-MB、VEGF是HIE患儿心、脑损伤的早期敏感指标，对HIE的早期诊断、病情程度判断及预后评估具有重要的参考价值。 [关键词] 新生儿缺氧缺血性脑病；血管内皮生长因子；肌酸磷酸激酶心型同工酶 [中图分类号] R722 [文献标识码]A [文章编号]1673-7210（2008）07（a）-039-02 The study of the dynamic changes of VEGF and creatine kinase MB isoenzyme in neonates with hypoxic ischemic encephalopathy CHEN Zhi-hui (Maternal and Child Health Care Hospital of Zhanjiang, Zhanjiang 524038, China) [Abstract] Objective: To explore the dynamic changes of creatine kinase MB isoenzyme(CK-MB) and vascular endothelial growth factor (VEGF) in neonates with hypoxic ischemic encephalopathy (HIE) and further explore the clinical senses.Methods: 51 cases of neonates with HIE treated were studied with involving 30 normal neonates as a control group. Blood samples were taken from both the HIE group and the control group 24 hours after birth, the third and the seventh day. The serum level of VEGF and that of CK-MB were measured.Results:The serum level of CK-MB and that of VEGF were higher in HIE group than in control group(P0.05). Conclusion:CK-MB and VEGF are the distinctive indicators for early diagnose of brain-heart damage which are of great value in early diagnosis, determining the degree and assessing prognosis for HIE. [Key words] Neonatal hypoxic ischemic encephalopathy; VEGF;CK-MB 新生儿缺氧缺血性脑病(HIE)是指在围生期窒息缺氧而导致脑的缺氧缺血性损伤，常缺乏典型临床症状、体征，部分患儿不能及时明确诊断，从而丧失最佳的治疗时机。深入研究HIE早期诊断的相关指标,做到早诊断、早治疗,对降低HIE患儿的病死率及减少后遗症的发生，具有非常重要的意义。 1 资料与方法 1.1 一般资料 2005年1月~2007年12月在我院产科出生的正常新生儿50例及窒息儿51例，其中，轻度HIE 14例，中度HIE 28例,重度HIE 9例。胎龄37~42周，体重2 500~4 000 g。性别和出生方式不限，无先天畸形及其他疾病,生母均身体健康。诊断标准及分度符合1996年杭州会议修订的新生儿HIE诊断依据和分度标准[1]。 1.2 标本采集 HIE组及正常对照组分别于出生后24 h、72 h、7 d采集空腹静脉血3 ml。 1.3 统计学处理 实验数据以x±s表示,采用方差分析及t检验、q检验。 2 结果 2.1 不同程度HIE与对照组的新生儿血清