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目的:检测不同程度、不同病程阶段新生儿缺氧缺血性脑病(HIE)患儿半胱氨酸天冬氨酸蛋白酶3(Caspase-3)和脑代谢物水平变化及临床意义。方法:选取确诊HIE轻度23例、中度18例、重度16例足月新生儿作为观察组,20例无窒息、无神经系统疾病的足月新生儿为对照组;所有实验对象于生后24h、3d、7d测血清Caspase-3,10d内行氢质子磁共振波谱(1 H-MRS)扫描,记录各代谢产物波峰下面积。结果:1在24h、3d、7d时,对照组与轻度HIE组血清Caspase-3水平无显著差异;轻度HIE组与中度HIE组、中度HIE组与重度HIE组血清Caspase-3水平有显著差异(即P<0.05);HIE组血清Caspase-3第3天较24h显著升高,随后显著下降。2对照组与HIE各组及HIE各组间的氮-乙酰天门冬氨酸(NAA)/肌酸(Cr)、乳酸(Lac)/Cr两两比较,差异有统计学意义(P<0.05),对照组与HIE组Cho/Cr比较,差异无统计学意义。结论:血清Caspase-3、脑代谢物水平与HIE患儿病情的轻重和病程进展密切相关,可作为早期诊断、病情判断、病程监测及预后评估的重要指标。
Objective: To investigate the changes and clinical significance of caspase-3 and brain metabolites in neonates with hypoxic-ischemic encephalopathy (HIE) at different stages and stages. Methods: Twenty-three neonates with mild HIE were selected as mild, 18 as moderate, 16 as full-term newborns as control group and 20 asymptomatic newborns with no neurological disease as control group. All the subjects were sacrificed after birth Serum Caspase-3 was detected by 1H-MRS scanning at 24h, 3d, 7d, and the area under the peak of each metabolite was recorded. Serum levels of Caspase-3 in mild HIE group and moderate HIE group, moderate HIE group and severe HIE group were significantly higher than those in control group and mild HIE group (P <0.05). Serum Caspase-3 level in HIE group was significantly higher than that on the third day and then decreased significantly. 2 There was significant difference between NAA / Cr and Lac / Cr in control group and HIE groups and HIE groups (P <0.05) , The control group and HIE group Cho / Cr comparison, the difference was not statistically significant. Conclusion: Serum levels of Caspase-3 and brain metabolites are closely related to the severity and course of disease in children with HIE and can be used as an important index for early diagnosis, disease judgment, disease course monitoring and prognosis evaluation.