窒息新生儿血清血管内皮生长因子的动态变化

Dynamic change of serum vascular endothelial growth factor (VEGF) level in newborn infants with asphyxia

为观察窒息新生儿血清血管内皮生长因子(VEGF)水平的动态变化并探讨其临床意义,我们应用双抗体夹心酶联免疫吸附法(ELISA)对正常新生儿(对照组30例)、窒息新生儿(窒息组47例)出生后即刻、第1天和第3天3个时间点血清VEGF水平进行检测。结果显示窒息组出生时血清VEGF水平显著上升,与对照组相比有极显著的差异(P<0.01),其水平上升的程度与新生儿窒息的严重程度有关,与血pH值及1分钟Apgar评分成负相关(P<0.05)。出生后第1天,轻度窒息组血清VEGF水平已明显下降。与对照组无显著性差异(P>0.05);重度窒息组血清VEGF水平虽然与对照组相比仍有显著性差异,但也出现下降趋势。到出生后第3天,窒息组与对照组相比已无显著性差异(P>0.05)。上述结果表明,动态检测窒息新生儿血清VEGF水平可望成为反映新生儿窒息程度以及转归的一个敏感和特异的指标,同时提示它可能在新生儿窒息的病理生理过程中发挥作用。

In order to observe the dynamic change in serum VEGF level in newborn infants with asphyxia and hence e-valuate its clinical value, serum VEGF level has been determined by the way of double-antibody sandwich ELISA technique consecutively at birth and on 1st day and 3rd day after delivery in each neonate of observation group (47 cases of neonatal asphyxia) and normal control group (30 cases). All the data revealed the results as follows; instantly at birth, serum VEGF level in asphyxia group was evidently increased, showing a significant difference in comparison with normal control group (P <0. 01). It was also found that the increasing degree of serum VEGF level was closely associated to the severity of asphyxic state and , furthermore, this level was showed to have a negative correlation with blood pH value and one-minute Apgar scoring of the cases (P<0. 05). Next, on 1st day after birth, serum VEGF level in mild asphyxia sub-group was evidently decreased, showing no significant difference from that in normal control group (P>0. 05); but, in severe asphyxia sub-group, this level showed no more significant difference from normal control group, although it still remained a tendency to decrease. Meaningfully, it was demonstrated that there had been no significant difference between asphyxia group and normal control. These results possibly suggest that dynamic assessment of serum VEGF level could be one of the sensitive and specific index evaluating the severity of asphyxia and its prognosis in affected newborn infants, at the same time, serum VEGF could be considered to play a role in the physiopathological course of neonatal asphyxia.