| Objective:By observing the changes of serum glial fibrillary acidic protein(GFAP),ubiquitin carboxyl terminal hydrolase-L1(UCH-L1)and Tau protein in term neonates with hypoxic ischemic encephalopathy(HIE),to explore their significances in early diagnosis and monitoring of HIE.Methods:This study conducted in the neonatal care unit of Affiliated Hospital of Yan'an University,over a period of one year from February 1,2019 till February 1,2020.46 term infants with hypoxic ischemic encephalopathy were enrolled,which included 13 newburns of mild HIE,21 of moderate HIE and 12 of severe HIE.Meanwhile,30 term newborns born in our hospital without asphyxia and neurological symptoms were selected as the control group.The general clinical data of all children were collected.1.5-2 ml peripheral venous blood was collected on the 1st,3rd and 7th day after birth in HIE group and control group.After coagulation,it was centrifuged at 3200 r / min for 5min.The serum was stored at-70 ? for standby.Enzyme linked immunosorbent assay(ELISA)was used to measure the GFAP,UCH-L1 and tau protein in serum of HIE and control group on the 1st,3rd and 7th day after birth.Then analyzed the datas with statistical software.Results:1 Changes of serum GFAP in term infants with HIE.1.1 Changes of serum GFAP among infants with different degrees of HIE at the same timeOn the first day after birth,the serum GFAP level of the four groups was different(F=13.85,P<0.05),which showed that the serum GFAP levels of moderate HIE werehigher than those of the control groups(P<0.05),and the serum GFAP levels of the severe HIE were significantly higher than those in the mild,moderate HIE and control groups(P<0.05,P<0.05,P<0.05).On the 3rd day,the levels of serum GFAP were significantly different among the four groups(F=9.67,P<0.05),showing that the levels of serum GFAP in mild,moderate and severe HIE groups were significantly higher than those in the control group(P<0.05,P<0.05,P<0.05),and the GFAP of severe HIE were higher than those of the mild and moderate HIE groups(P<0.05,P<0.05).On the 7th day,there were significant differences in serum GFAP levels among the four groups(F=31.22,P<0.05).The manifestations were that the serum GFAP levels of the moderate and severe HIE groups were higher than the controls(P<0.05,P<0.05),the serum GFAP levels of the moderate and severe HIE were higher than the mild(P<0.05,P<0.05),and the serum GFAP of the severe HIE were higher than the moderate(P<0.05).1.2 Changes of serum GFAP within groups at different timeThere was no significant difference in the level of serum GFAP within the control group on 1st,3rd and 7th days after birth(F=1.26,P>0.05);there was no significant difference in the level of serum GFAP within the mild HIE group at 1,3 and 7 days after birth(F=5.86,P>0.05);there was significant difference in the level of serum GFAP within the moderate HIE group at 1,3 and 7 days after birth(F=13.61,P<0.05),which was manifested by the difference in the level of serum GFAP between the first and the seventh days after birth.It was significantly higher than that on the 3rd day after birth(P< 0.05,P < 0.05,respectively);there was a significant difference in serum GFAP levels within the severe HIE group on the 1st,3rd and 7th days after birth(F = 18.13,P < 0.05),which was manifested that the serum GFAP levels on the 1st and 7th days were significantly higher than those on the 3rd day(P < 0.05,P < 0.05).2 Changes of serum UCH-L1 in term infants with HIE.2.1 Changes of serum UCH-L1 among infants with different degrees of HIE at the same time.The serum UCH-L1 levels of full-term neonates on the first day after birth were significantly different among the four groups(F=9.65,P<0.05),which showed that the serum UCH-L1 levels of the moderate and severe HIE were higher than the control groups(P<0.05,P<0.05),the serum UCH-L1 of the moderate and severe HIE were higher than the mild HIE(P<0.05,P<0.05),the serum UCH-L1 of the severe HIE were significantly higher than the moderate(P < 0.05).On the third day,the serum UCH-L1 levels were significantly different among the four groups(F=15.06,P<0.05),which showed that the serum UCH-L1 of the moderate and severe HIE were significantly higher than the controls(P<0.05,P<0.05),the serum UCH-L1 levels of the moderate and severe HIE were significantly higher than the mild(P<0.05,P<0.05).On the 7th day,there were significant differences of serum UCH-L1 among the four groups(F=17.35,P<0.05).The results showed that serum UCH-L1 levels in moderate and severe HIE groups were significantly higher than those of the control groups(P<0.05,P<0.05),serum UCH-L1 levels in moderate and severe HIE groups were significantly higher than those in mild HIE groups(P<0.05,P<0.05),serum UCH-L1 of severe HIE were higher than the moderate(P < 0.05).2.2 Changes of serum UCH-L1 within groups at different time.There was no significant difference in serum UCH-L1 level within the control group at 1,3 and 7 days after birth(F=0.02,P>0.05);there was no difference of UCH-L1 within the mild HIE group at 1,3 and 7 days after birth(F=2.11,P>0.05);there was no difference of UCH-L1 within the moderate HIE group at 1,3 and 7 days after birth(F=2.33,P>0.05);and there was no difference of UCH-L1 within the severe HIE group at 1,3 and 7 days after birth(F=6.78,P>0.05).3 Changes of serum Tau protein in term infants with HIE.3.1 Changes of serum Tau protein among infants with different degrees of HIE at the same time.The serum Tau protein level of term neonates on the first day after birth wassignificantly different among the four groups(F=13.16,P<0.05).The manifestations were that the serum Tau protein levels of the moderate the severe HIE groups were higher than the controls(P<0.05,P<0.05),the serum Tau protein levels of the severe HIE were higher than the mild and moderate(P<0.05,P<0.05);On the 3rd day,the levels of serum Tau protein were significantly different among the four groups(F=9.16,P<0.05),which showed that the levels of serum Tau protein in the moderate and severe HIE were higher than the controls(P<0.05,P<0.05),the Tau protein of the moderate and severe HIE were higher than the mild(P<0.05,P<0.05);On the 7th day,the level of serum Tau protein was significantly different among the four groups(F = 29.84,P < 0.05),which showed that the level of serum Tau protein in severe HIE group was significantly higher than that in moderate,mild HIE and control groups(P < 0.05,P < 0.05,P < 0.05).3.2 Changes of serum Tau protein within groups at different time.There was no significant difference in the level of serum Tau protein within the control groups at 1,3 and 7 days after birth(F=11.02,P>0.05);there was no significant difference in the level of serum Tau protein within the mild HIE at 1,3 and 7 days after birth(F=0.73,P>0.05);there were significant differences of serum Tau protein within the moderate HIE groups at 1,3 and 7 days after birth(F=8.37,P<0.05),which showed the level of serum Tau protein on the third day was significantly higher than that in the first and the seventh days(P<0.05,P<0.05),the level of serum Tau protein in the severe HIE group on the first,third and seventh days after birth were significantly different(F=49.00,P<0.05),which showed that the level of serum Tau protein on the seventh day was significantly higher than that on the first and third days(P<0.05,P<0.05).4 Comprehensive analysis of correlation between serum GFAP?UCH-L1 ?Tau protein and the degree of HIE.There was correlation between serum GFAP and HIE in 46 cases at the 1st?3rd and 7th days after birth(r=0.74,0.53,0.90;P<0.05).There was correlation between serum UCH-L1 and 46 cases of HIE at the 1st,3rd and 7th days after birth(r=0.73,0.81,0.80;P<0.05).Serum Tau protein as correlated with 46 cases of HIE at the 1st,3rd and7 th days after birth(r=0.72,0.68,0.94;P<0.05).Conclusions:1.Serum GFAP?UCH-L1 and Tau protein have good correlation with different stages of HIE clinical grading and course.The more severe the condition is,the higher the level of GFAP?UCH-L1 and Tau protein will be?2.Serum GFAP?UCH-L1 and Tau proteins may could be used as indicators for early diagnosis,treatment and monitoring of HIE in term infants. |
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