缺氧缺血性脑病新生儿脂联素、胰岛素样生长因子-1的变化

摘要

目的：探讨缺氧缺血性脑病(HIE)新生儿血清胰岛素样生长因子-1(IGF-1)、脂联素(APN)水平的变化。方法选择足月HIE新生儿52例(重度HIE组15例，中度HIE组20例，轻度HIE组17例)，测定脐血及生后3~5 d(HIE急性期)、10~14 d(HIE恢复期)的血清IGF-1、APN水平；另选同期出生的20例足月健康新生儿作为对照组。结果轻、中、重度HIE组及对照组四组间脐血及生后3~5 d时APN、IGF-1水平的差异有统计学意义(P均<0.01)，均随HIE程度加重而下降，两两比较差异有统计学意义(P均<0.05)；HIE恢复期新生儿APN、IGF-1水平显著增加，但APN水平中度HIE组和重度HIE组仍低于对照组，差异有统计学意义(P均<0.05)；重度HIE组IGF-1仍低于对照组，差异有统计学意义(P<0.05)；HIE患儿脐血、急性期血清IGF-1、APN水平呈显著正相关(r=0.53、0.61，P均<0.01)。结论 HIE患儿血清IGF-1、APN水平降低与HIE的病理生理过程密切相关，可作为病情程度的判断指标之一，对临床诊断及预后的判断具有指导意义。%Objective To explore the changes and clinical value of serum insulin like growth factor-1 (IGF-1) and adiponectin in newborns with hypoxic ischemic encephalopathy (HIE). Methods Fifty-two HIE newborns were recruited in this study, including 15 severe, 20 moderate and 17 mild HIE newborns. Twenty healthy newborns were selected as controls. Serum levels of IGF-1 and adiponectin were detected 3-to-5 days (acute period) and 10-to-14 days (recovery period) after birth. Results Serum levels of IGF-1 and adiponectin in the acute period differed signiifcantly among groups of different severity (P<0.05). Serum levels of IGF-1 and adiponectin were decreased with the increase of HIE severity. The level of adiponectin in moderate and severe HIE was lower than that in mild HIE (P<0.05). In recovery period, the level of IGF-1 in severe HIE was lower than that in control (P<0.05). Serum levels of IGF-1 and adiponectin in the acute period was positivity correlated with those in umbilical cord blood of HIE newborns (r=0.531, r=0.611, P<0.01). Conclusions Decreased levels of IGF-l and adiponectin in HIE newborns are correlated with the pathological process of HIE, and can be regarded as indices for severity of HIE. IGF-l and adiponectin is of signiifcance in the clinical diagnosis and prognosis of HIE.