| Hypoxic ischemic (HIE) of newborn is the damage in brain because of perinatal hypoxia or asphyxiation. HIE is an important cause that made newborn dead in perinatl stage. It often make serious sequela of nervous system, and make the predisposition of the whole population descent. Recently years, although scholar of international and internal have proceed a lot of investigation, and have made a lot of achievement in pathogenesis, diagnosis and therapy in HIE, the pathogenesis of HIE is still not clear fully. There are many altercation in this problem, but it have not dependable therapeutic tool yet. So it is an hot spot in neonatology. Most study think that multiple factor has take part in the process in HIE. After ischemia and hypoxia, brain energy metabolism shutdown, cerebral vessels self-adjustment was damaged, excitatory amino acids (EAA) releas largely, Ca2+ in cell overloading and much oxygen-derived free radidicals releas ,action of nitrogen monoxide (NO), β- endorphin, neutrophil, blood platelet active factor and so on, all this may cause neur damage and brain cells dead and so on ,the faction of brain have been damaged in aniso-level. Many investigation show that the change of some cytokine and enzyme have important significance in episod of HIE. In order to evaluate the action of tumor nerosis factor-alpha (TNF-a) NSE and find the relationship between TNF-a,NSE and HIE, TNF-a, NSE were measured by enzyme-linked immunoadent assay (ELISA) method in 50 Neonates with hypoxic ischemic encephalpathy (HIE) on difference stage and difference degree and 20 healthy newborn who was born 1 day later as control. The result show that in light group serum TNF-a level increased significantly in patients with HIE at the first day after birth than those in control group (p<0.05), then the serum TNF-a level in patients with HIE at the third and seventh day after birth begin descent, and have no significance in contrast with those in control group (p>0.05). The serum TNF-a level in patients with HIE at the first day and the third day increase significantly in miderate .The serum TNF-a level in patients with miderate group of HIE at the first day after birth increased significantly than those in control group (p<0.01), The serum TNF-a level in patients with miderate group of HIE at the third day after birth increased significantly than those in control group (p<0.05); but at the seventh day after birth didn't have significance with those in control group (P>0.05). The serum TNF-a level increased significantly in patients with the severe group of HIE at the first day, the third day and the seventh day after birth increased significantly than those in control group (p<0.01), among three groups of HIE, the serum TNF-a level in patients with HIE at the first day increased significantly than those at the third day (p<0.05), the serum TNF-a level in patients with HIE at the third day didn't have significance with those at the seventh day (p>0.05), so we can find that the serum TNF-a level increased significantly in patients with mild, moderate and severe group of HIE at the ealier period, and the serum TNF-a level increased by severity of illnesss, the serum TNF-a level of the mild group went down fastly. So the serum TNF-a level of the mild group may have protective function when neonates had brain injury, and the serum TNF-a level of neonates can contribute to diagnose illness and analyse severity of illnesss at the earlier period. The result show that the serum NSE level of the moderate and severe group in patients with HIE at the third day and seventh day after birth increased significantly than those in control group (p<0.01), while the serum NSE level of the mild group didn't have significance with those in control group (P>0.05). Although the serum NSE level of the third and the seventh day is lower than that of the first day, the serum NSE level of the severe group at the first, third day and seventh days increased significantly than those in control group (P<0.01). There is no differece a... |
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