The Study On The Relationship Between The Plasma Levers Of Adrenomedullin,Endothelin-1 And Brain Injury In Neonates With Asphyxia

Objective In our study infants with asphyxia were picked as observation group. The levers of ADM and ET-1 in plasma of neonates with asphyxia in acute and restorative period and different degree of brain injury were observed respectively. To probe the value of early diagnosis and prognosis evaluation of ADM and ET-1 in brain injury after asphyxia. Methods1 Group:70 infant with asphyxia were picked randomly and subdivided into four groups : simple asphyxia , mild hypoxic ischemic encephalopathy (HIE) , moderate HIE and serious HIE according to clinical manifestation, symptoms and signs of nervous system and results of cerebral CT. 28 normal full term infants born at the same period were selected randomly as control group.2 The measurement of plasma ET-1 and ADM: Plasma ADM and ET-1 levels of asphyxia infants were tested by RIA in 12 hours after birth (acute period) and 14 days after birth ( restorative period ) respectively.2 The plasma ADM and ET-1 levels of normal infants were tested by RIA in 12 hours after birth . Results1 Comparison in groups of HIE and simple asphyxia: The levers of ADM and ET-1 in plasma with HIE in acute period were significantly higher than those in groups of control and simple asphyxia (P<0.05) ,there were no significant difference between control and simple asphyxia group (P>0.05 ) .2 Comparison in different degree of brain injury: In acute duration the plasma levers of ADM and ET-1 increased gradually in groups of control, mild,moderate and severe HIE. The plasma levers of ADM and ET-1 in severe HIE group were significantly higher than those in groups of control, mild and moderate HIE (P<0.05) ,there were no significant difference among the groups of controls, mild and moderate HIE(P>0.05). In HIE groups the levers in restorative period are significantly decreased than those in acute period (P<0.05).3 Comparison between HIE with intracranial hemorrhage (ICH) and without ICH: The levers of ADM and ET-1 in plasma of HIE infants with ICH were higher than these without ICH in acute period and restorative period. The levers in acute period are higher than those in restorative period and there were significant difference (P<0.05).4 Comparison of correlation between ADM and ET-l: There were positive correlation between ADM and ET-1 in acute period (r=0.561,P<0.05) ;there were no correlation between ADM and ET-1 in restorative period (r=0.173,P>0.05 ) Conclusions1 In the early stage the levers of ADM>ET-1 increased dramatically in infants with HIE while the levers of simple asphyxia increased slightly which shows that ADM, ET-1 can be regarded as early markers of brain injury after asphyxia.2 Degree of increased levels of ADM, ET-1 was related to degree of brain injury after asphyxia and levers of ADM, ET-1 in severe HIE kept higher lever during restorative period which shows that the measurements of ADMn ET-1 would have direct significance to predict the degree of brain injury and prognosis.3 The lever of ADM ^ ET-1 increased significantly in infants with sever HIE and intraventricular hemorrhage which shows that higher lever of ADM ^ ET-1 might participate in pathogenesis of severe brain injury after asphyxia.4 In HIE acute period ADM have positive relationship with ET-1 which indicated that ADM and ET-1 commonly participate in pathogenesis of brain...