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的临床研究

The study of the dynamic changes of VEGF and creatine kinase MB isoenzyme in neonates with hypoxic ischemic encephalopathy

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24h、72h、7d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24h表达为最高峰,与对照组比较差异有显著性(P<0.01),随后下降;两者均随病情加重而升高;其中,HIE中度组第7天CK-MB降至正常水平,重度组仍明显高于对照组(P<0.01),而VEGF在72h、7d时与对照组比较差异无显著性(P>0.05)。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。

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 （P〈0.01）; and both became higher correspondently with the worsening condition of HIE; the two levels peaked 24 hours after birth and later began to drop. The serum CK-MB level of moderate HIE dropped to normal level on the seventh day. The level dropped obviously for severe HIE on the seventh day ,however still significantly higher than that in control group （P〈0.01）. No significant difference was shown on VEGF level between HIE and control group （P〉0.05）. 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.