新生儿缺血缺氧脑病脑利钠肽与血清脂联素的相关性

Correlation Between Full-term Neonates with Hypoxic-ischemic Encephalopathy and Their Brain Natriuretic Peptide and Serum Adiponectin Levels

目的:通过观察临床分度和分期不同的缺氧缺血性脑病(HIE)新生患儿脑利钠肽(BNP)、血清脂联素的变化及其相关性,探索可早期诊断、判断患儿病情进展和预后的量化指标。方法:选择60例在我院诊治的缺氧缺血性脑病足月新生儿,根据临床分度标准将其分为轻度亚组(21例)、中度亚组(25例)和重度亚组(14例)。测定脑病各组急性期和恢复期的血浆BNP、血清脂联素的水平。选择同期我院分娩的20例正常足月新生儿作为对照组。结果:缺氧缺血性脑病组急性期血清脂联素水平显著低于对照组(P<0.05),随着缺氧缺血性脑病病情的加重,血清脂联素水平逐级下降(P<0.05)。脑病各组恢复期血清脂联素水平较急性期显著增加(P<0.05);轻度和中度组的急性期血浆BNP水平显著高于对照组(P<0.05),显著低于重度亚组(P<0.05),恢复期较同组急性期显著下降(P<0.05)。缺氧缺血性脑病患儿BNP(r=0.567)、血清脂联素水平与病情呈显著负相关;与临床分度(r=0.403)呈显著负相关,与病程(r=0.328)呈显著正相关。结论:BNP、脂联素可作为早期诊断、判断缺氧缺血性脑病患儿病情进展和预后的量化指标,联合监测将对该病的防治工作提供新的思路和治疗新靶点。

Objective：To explore clinical indices for early diagnosis,judging devolopment and prognosis in full-term neonates with hypoxic-ischemic encephalopathy（HIE）,by observing the variance of serum adiponecti and brain natriuretic peptide（BNP） and its corelation with clinical gradings and stages of HIE.Methods：This study selects 60 full-term neonates with HIE（HIE group） and 20 healthy full-term neonates（control group）.Full-term neonates with HIE were divided into 3 groups according to their clinical stages： mild group（21 cases）,moderate group（25 cases） and severe group（14 cases）.Serum adiponectin,plasma BNP levals in acute stage and recovery stage were measured.Results：In acute stage,serum adiponectin levels in HIE group were significantly lower than that in control group（P0.05）.With the deterioration of HIE,serum adiponectin levels significantly decreased by grades（P0.05）,while significantly increased in recovery stage（P0.05）.In acute stage,plasma BNP levels in mild and moderate groups were significantly higher than that in control group（P0.05）,but strikingly lower than that in severe group（P0.05） and its leves in recovery stage were significantly reduced（P0.05）.Serum adiponectin and BNP（r=0.567） levels negatively correlated with pathogenetic conditions and clinicl gradings（r=0.403）,while positively correlated with course of disease（r=0.328）.Conclusions：Adiponectin and BNP may be good indices for early diagnosis,judging devolopment and prognosis of full-term neonates with HIE.Monitoring these indices would provide us with new methods and targets for HIE＇s prevention and treatment.