血清胶质纤维酸性蛋白与兴奋性氨基酸在脑瘫早期诊断中的价值及机制研究

The value and mechanism of serum GFAP and EAA in early diagnosis of cerebral palsy

目的 明确胶质纤维酸性蛋白与兴奋性氨基酸水平在新生儿脑损伤早期表达的变化及造成脑损伤的机制、血清胶质纤维酸性蛋白与兴奋性氨基酸在新生儿脑瘫早期诊断与预测的价值.方法 本研究选择脑瘫高危儿为研究对象,采用反相高效液相色谱荧光法检测血清兴奋性氨基酸浓度、酶联免疫吸附法检测胶质纤维酸性蛋白浓度,随访12个月,对脑瘫儿的发生情况行统计分析.结果 脑瘫患儿各组及正常组胶质纤维酸性蛋白、谷氨酸和天门冬氨酸水平比较差异均有统计学意义且显著高于正常组[胶质纤维酸性蛋白：（119.46±43.68）、（119.46±43.68）、（62.57±35.31）、（134.02±32.79） ng/L ,谷氨酸：（7.52±3.94）、（6.49±2.88）、（8.15 ±2.03）、（1.72±0.59） μmol/L ,天门冬氨酸：（3.81±1.09）、（4.23±1.91）、（3.67±2.14）、（1.35±0.71） μmol/L;F值分别为4.117、4.117、4.117,P均〈0.05],出生后高危组、围生期高危组和出生前高危组患儿胶质纤维酸性蛋白、谷氨酸和天门冬氨酸水平比较差异均无统计学意义（P均〉0.05）;痉挛组、徐动组、混合组及正常组胶质纤维酸性蛋白、谷氨酸和天门冬氨酸水平比较差异均有统计学意义且显著高于正常组（F值分别为5.032、6.004、3.792,P均〈0.05）痉挛组、徐动组、混合组胶质纤维酸性蛋白、谷氨酸和天门冬氨酸水平组间比较差异均无统计学意义（P均〉0.05）.结论 血清兴奋性氨基酸浓度及胶质纤维酸性蛋白对脑瘫高危儿的早期诊断具有一定的价值,血清兴奋性氨基酸浓度及胶质纤维酸性蛋白的浓度水平与脑瘫患儿的脑损伤程度及时间具有相关性.

Objective To make clear glial acidic protein and excitatory amino acid levels in the early expression of neonatal brain injury and the mechanism of brain injury,and the value of early diagnosis and prediction of serum glial fiber acidic protein and excitatory amino acid in neonatal cerebral palsy.Methods This study chose high-risk infants with cerebral palsy as the research object,the concentration of excitatory amino acid and enzyme linked immunosorbent assay were detected by reverse phase high performance liquid chromatography,followed up for 12 months,the occurrence of cerebral palsy was analyzed statistically.Results Compared with the normal group of glial fibrillary acidic protein,glutamic acid and aspartic acid levels,three indexes of children with cerebral palsy were higher than normal group（glial fibrillary acidic protein：（119.46±43.68）,（119.46±43.68）,（62.57±35.31）,（134.02±32.79） ng/L;glutamic acid：（7.52±3.94）,（6.49±2.88）,（8.15 ±2.03）,（1.72±0.59） μmol/L;aspartic acid：（3.81±1.09）,（4.23±1.91）,（3.67±2.14）,（1.35±0.71） μmol/L;F=4.117,4.117,4.117;P〈0.05）.Glial fibrillary acidic protein,glutamic acid and aspartic acid levels in the high-risk group,the perinatal high-risk group and the pre birth high-risk group had no significant difference （P〉0.05）.The levels of serum glial fiber acidic protein,glutamic acid and aspartate in children with cerebral palsy were higher than those in the normal group,comparison between spastic group,athetotic group and mixed group（F=5.032,6.004,3.792）,there was no significant difference in the levels of glial acidic protein,glutamic acid and aspartate（P〉0.05）.Conclusion The concentration of excitatory amino acids and acidic protein in the serum of the patients with high risk of cerebral palsy has some value,the concentration of serum excitatory amino acid and the concentration of glial fiber acidic protein are correlated with the degree of brain injury and the time in children with cerebral palsy.