血清胰岛素样生长因子Ⅰ及生长激素与新生儿缺氧缺血性脑病的关系

Relationship between serum levels of insulin-like growth factorⅠand growth hormone and neonatal hypoxic-ischemic encephalopathy

摘要:

目的：研究新生儿缺氧缺血性脑病（HIE）血清胰岛素样生长因子Ⅰ（IGF-Ⅰ）和生长激素（GH）水平， 探讨血清IGF-Ⅰ，GH与HIE严重程度之间的关系。方法：测定实验组53例HIE新生儿（其中轻度30例、中度15例、重度8例）生后72 h内、26～28 d血清IGF-Ⅰ和GH水平，以30例正常新生儿作对照；HIE组新生儿分别在急性期和恢复期做新生儿神经行为测定（NBNA），分析血清IGF-Ⅰ和GH与HIE严重程度及与NBNA之间的关系。结果：轻、中、重度 HIE新生儿血清 IGF-Ⅰ 水平在生后72 h内分别为59.65±29.61 ng/mL、33.56±17.32 ng/mL、23.58±13.57 ng/mL，生后26～28 d分别为89.26±48.65 ng/mL、71.46±38.35 ng/mL、54.39±26.39 ng/mL。对照组在72 h及26~28 d时，IGF1水平为71.23±35.42 ng/mL、96.54±52.38 ng/mL，与实验组比较均P<0.01。病情越重血清IGF-Ⅰ水平越低（P＜0.05)。血清GH水平与HIE的严重程度无相关性。HIE组血清IGF-Ⅰ水平在急性期和恢复期均与NBNA高度相关（r=0.295, P＜0.05； r=0.263,P＜0.05），而GH无论在急性期和恢复期均与NBNA分值没有相关性。结论：测定新生儿HIE血清IGF-Ⅰ水平可判断HIE的严重程度，血清IGF-Ⅰ水平可能影响HIE新生儿的预后。［中国当代儿科杂志，2007，9（1）：22-24］

Abstract:

OBJECTIVE: To study the serum levels of insulin-like growth factorⅠ(IGF-I) and growth hormone (GH) in neonates with hypoxic-ischemic encephalopathy (HIE) and to investigate the relationship of serum levels of IGF-I and GH with the severity of HIE. METHODS: Serum levels of IGF-I and GH were measured within 72 hrs (acute stage) and on the 26-28th days (convalescence stage) of life in 53 HIE neonates. There were 30 babies in the mild HIE group, 15 babies in the moderate HIE group, and 9 babies in the severe HIE group. Thirty normal newborns were used as the control group. Neonatal behavioral neurological assessment (NBNA) was performed on HIE neonates at the acute and convalescence stages. RESULTS: The IGF-I levels of the mild, moderate and severe HIE groups measured within 72 hrs of life were 59.65±29.61, 33.56±17.32, and 23.58±13.57 ng/mL respectively and those of the three HIE subgroups on the 26-28th days after birth were 89.26±48.65, 71.46±38.35, and 54.39±26.39 ng/mL respectively. The serum IGF-I levels of HIE neonates at both acute and convalescence stages were significantly lower than those of the control group(71.23±35.42 and 96.54±52.38 ng/mL respectively; both P< 0.01), and associated with the severity of HIE as well as NBNA scores. GH levels were not significantly correlated to the severity of HIE and NBNA scores. CONCLUSIONS: Serum IGF-I levels can be used as a marker for estimating the severity and the outcome of neonatal HIE. ［Chin J Contemp Pediatr, 2007, 9 (1) :22-24］