新生儿缺氧缺血性脑病血清INS和LEP及IGF-Ⅰ水平检测

Levels of INS,LEP and IGF-Ⅰ in neonates with hypoxic-ischemia encephalopathy

目的探讨新生儿缺氧缺血性脑病(HIE)血清胰岛素(INS)、瘦素(LEP)、胰岛素样生长因子I(IGF-Ⅰ)水平变化及意义。方法应用放射免疫分析测定了40例新生儿缺氧缺血性脑病急性期与恢复期血清INS、LEP和IGF-I的水平并与30名正常新生儿作比较。结果新生儿窒息时HIE组与正常对照组比较血清IGF-Ⅰ下降,瘦素升高,且差异有统计学意义(P<0.01),HIE组患儿急性期血中IGF-Ⅰ下降,恢复期有所回升,差异有统计学意义(P<0.01),重度HIE组急性期与恢复期瘦素比较差异有统计学意义(P<0.05),血浆INS水平与对照组差异无统计学意义(P>0.05)。结论 IGF-Ⅰ在中枢神经系统中起重要保护作用,INS、LEP参与IGF-Ⅰ的代谢过程,并与新生儿缺氧缺血性脑病病理过程密切相关。

Objective To explore the changes and clinical significance of the levels of plasma INS, LEP and Insulin-Like Growth Factor I （IGF-I） in neonates with hypoxic-ischemia encephalopathy （HIE）. Methods The plasma levels of INS, LEP and IGF-I were determined with RIA in 40 neonates with HIE both during acute stage and convalescence as well as in 30 controls. Results The levels of plasma IGF-I in the patients were significantly lower than those in the controls （P 〈 0.01） and the levels of plasma LEP increased compared to those in the controls （P 〈 0.01 ）. During the acute stage, IGF-I decreased in the patients, but during the recovery, it rose again （P 〈 0.01 ）. In LEP levels, there was a significant difference between the acute stage and the recovery stage in the serious patients with HIE （P 〈 0.05）. In INS levels, there was no significant difference between the patients and the controls. Conclusions The determination of plasma INS, LEP and IGF-I levels is helpful for the prediction and treatment in neonates with HIE.