Abstract:OBJECTIVE: To investigate the cerebrospinal fluid (CSF) and plasma vascular endothelial growth factor (VEGF) and nitric oxide (NO) levels in newborns with different degrees of hypoxic-ischemic encephalopathy (HIE) and to study the correlation between NO and VEGF. METHODS: CSF and plasma samples from 38 newborns with HIE (16 mild, 13 moderate and 9 severe) were obtained within the first 24 hours of life. CSF samples of 13 neonates without nervous system diseases were used as controls. The levels of VEGF and NO in CSF and plasma were measured by ELISA and nitrate reduction respectively. The correlation between VEGF and NO was analyzed by Pearson correlation analysis. RESULTS: The CSF NO levels in the moderate and severe HIE neonates ( 12.65± 1.44 and 14.82± 1.91 μmol/L) were higher than those of the controls ( 8.11± 1.33 μmol/L) and the mild HIE neonates ( 9.21± 1.74 μmol/L) (P< 0.01). The highest CSF NO level was found in the severe HIE neonates, whereas that of the mild HIE neonates was similar to that of the controls. The CSF VEGF levels in the three HIE groups ( 12.30± 1.24, 13.60± 0.85 and 14.79± 1.63 pg/ml) were significantly higher than that of controls ( 10.94± 1.48 pg/ml) (P< 0.01). The more serious the disease, the higher the VEGF level. There was a significant positive correlation between VEGF and NO levels in the CSF of neonates with HIE (r= 0.617, P< 0.01). There were no significant differences in plasma VEGF and NO levels among the three HIE groups. CONCLUSIONS: VEGF may be useful for early diagnosis and severity and prognosis evaluation of HIE.
