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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 serum vascular endothelial growth factor (VEGF) and brain metabolites in neonates with hypoxic-ischemic encephalopathy (HIE) and the correlation between VEGF and brain metabolites and to explore the early diagnosis and prognosis of VEGF and HIE And the related mechanism of clinical relevance. Methods: Fifteen cases of mild HIE, moderate HIE and severe HIE full-term newborns were selected as the observation group and 15 full-term newborns without asphyxia and without nervous system diseases were selected as the control group. All the experimental subjects Serum VEGF was detected on day 3, day 7, and day 10, 1H proton MR spectroscopy was performed on the 10th day, and the area under the peak of each metabolite was recorded. Results: 1 In the observation group, VEGF increased at 24h after birth and then decreased gradually. At 24, 3d, and 7d, the levels of VEGF in mild HIE group and moderate HIE group, moderate HIE group and severe HIE group Serum VEGF levels were significantly different (P <0.05). On the 10th day, there was no significant difference in serum VEGF between the control group and the HIE group (P> 0.05). 2 Comparison between NAA / Cr, NAA / Lac / Cr in control group, HIE group and HIE group showed significant difference Statistical significance (P <0.05), the control group and HIE group Cho / Cr comparison, the difference was not statistically significant. 3 serum VEGF levels and NAA was negatively correlated, plasma VEGF levels and Lac was positively correlated. Conclusion: VEGF may be used as an important indicator of neonatal HIE early diagnosis, classification, prognosis, simple and easy to promote.