| Objective:To search the change of the neuron-specific enolase (NSE) serum level and the clinical significance in the infants with hypoxic-ischemic encephalopathy (HIE). And to explore the changes of pigment epithelium derived factor (PEDF) serum level and vascular endothelial growth factor(VEGF) in newborns with hypoxic-ischemic encephalopathy(HIE) in order to know clinical value.Methods:1. 20, 20, 20 infants were defined as mild group,moderate group and severe group from 60 neonates with HIE , respectively. Control group was 20 infants with no asphyxia and other nervous system diseases. Serum level of NSE were measured at the first day, the third day and the seventh day after birth by ELISA method.2. All of the mature infants who were checked the neuron-specific enolase (NSE) serum level were performed with DST at the age of six months.3. Each group has 20 newborns from control group, mild HIE group, moderate HIE group and severe HIE group. Serum levels of PEDF and VEGF in blood were measured at the first day, the third day and the seventh day after birth with Sandwich ELISA. Lymphocyte extracted from. remained blood cells were detected to express VEGF and PEDF with RT-PCR.4. RT-PCR detection: use two-steps RT-PCR to detect the mRNA. The first reactive condition is 37℃15min→85℃5sec; human tissue factor VEGF, the sequence of the forward primer is 5'- GAGTGGTTGACCTTCCTCCA-3'; the sequence of the reverse primer is 5'- GGGCAGAGCTGAGTGTTAGC-3'. Human tissue factor PEDF, the sequence of the forward primer is 5'-AAGAACCTCAAGAGT GCCTCCC-3'; the sequence of the reverse primer is 5'-AAGAACCTCAAGAGT GCCTCCC-3'. The PCR reactive condition is: 95℃10sec→40×(95℃5sec, 60℃30sec) . Electrophoresis the amplifying production in the 2% gelose.Result:1. It was great difference among the neuron-specific enolase (NSE) serum level of HIE degree groups(F=351.007,P=0.000), Means from high to low: severe HIE group(mean was 79.953), moderate HIE group(mean was 51.615), control group(mean was 38.915), mild HIE group(mean was 38.520). Any two groups were significantly different except control group and mild HIE group. There were great different among the neuron-specific enolase (NSE) serum level of three time stages after birth(F=351.007,P=0.000). Means from high to low: the first day(mean was 62.669), the third day(mean was 50.376), the seventh day(mean was 40.708). Any two time stages were great different. Interaction was great different between time and HIE degree(F=72.295,P=0.000). At the first day, any two HIE degree groups were significantly different except control group and mild HIE group. At the third day, any two HIE degree groups were significantly different except control group and mild HIE group. At the seventh day, any two HIE degree groups were significantly different except control group and mild HIE group, and mild HIE group and moderate HIE group. There was no difference between control group and mild HIE group at three time stages. There was great different between the moderate HIE group and the severe HIE group at three time stages. Any two time stages were great different at the moderate HIE group or severe HIE group. The neuron-specific enolase (NSE) serum level of the infants with moderate HIE group and severe HIE group were the highest at the first day, and then descended. There was no different between the moderate HIE group at the seventh day and control group.2. The higher the neuron-specific enolase (NSE) serum level, the worse the prognosis was. The NSE serum level were great different among the prognosis groups(F= 41.336,P=0.000). The means of prognosis groups: normal prognosis(49.0354), questionable prognosis(mean was 62.4848), abnormal prognosis (mean was 75.8833). The interaction was significantly different between the prognosis and time stage(F=11.737, P=0.000). There were significantly different among three time stages(F=78.561, P=0.000). Any prognosis interior groups were diffirent(P< 0.01). There were great diffirent among prognosis at three time stages(P<0.01). There were great diffirent between any two prognosis groups at any time stage except questionable prognosis group and abnormal group at the first day. The lower the NSE serum level descended, the worse the prognosis was.3. It was great difference among the pigment epithelium derived factor(PEDF) serum level of HIE degree groups(F=293.609,P=0.000), means from high to low: mild HIE group(mean was 3.743), control group(mean was 3.735), severe HIE group (mean was 2.081), moderate HIE group(mean was 1.991). The compare of any two groups were great diffirent except control group and mild HIE group, moderate HIE group and severe HIE group. There were great different among the pigment epithelium derived factor(PEDF) serum level of three time stages after birth(F=7.238,P=0.001), means from high to low: the third day(mean was 3.122), the first day(mean was 2.787), the seventh day(mean was 2.753). Any two groups of the pigment epithelium derived factor(PEDF) serum level were great different among three time stages except the first day and the seventh day. Interaction was different between time and HIE degree(F=2.210, P=0.045). At three time stages, any two HIE degree groups were significantly different except control group and mild HIE group, moderate HIE group and severe HIE group. The PEDF serum levels of control group or mild HIE group were similar at the three time stagescontrol group or mild HIE group(P>0.05). The PEDF serum levels of moderate HIE group or severe HIE group were significant different at the three time stagescontrol group or mild HIE group(P=0.000), and any two time stages were great different except the first day and the seventh day.4. The vascular endothelial growth factor(VEGF) serum levels were similar among control group, mild HIE group, moderate HIE group and sever HIE group (F=0.467, P=0.707). There was no difference at the three time stages (F=0.995, P=0.372) . There was no interaction between HIE degree and time (F= 1.047, P=0.397) .Conclusion:1. The NSE serum level concerned with the brain injury because of HIE. The more seriously brain injuried, the higher the NSE serum level was. the NSE serum level of the infants with the mild HIE group assended softly. The NSE serum level of the moderate HIE group were higer than that of the mile HIE group, that of the severe HIE were the highest among the four degree HIE groups. The NSE serum level was the most highest level at the first day, and then declined. The NSE serum level of moderate HIE group was similar with that of control group at the seventh day. 2. At the time of the birth, the severer of the clinical sysptoms of HIE, or the higher of the neuron-specific enolase (NSE) serum level was, or the severer of the clinical sysptoms of HIE, the worse the prognosis was.3. The worse the clinical symptoms were, the lower the PEDF serum level were. The PEDF serum level varied from the time going. The most highest level was at the third day, the PEDF serum level at the first day was resemble as that at the seventh day. Serum levels of VEGF didn't vary with the time going, the brain injury, and the PEDF serum level. |
PDF Full Text Request