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目的探讨新生儿缺氧缺血性脑病(HIE)血清胰岛素(INS)、瘦素(LEP)、胰岛素样生长因子I(IGF-Ⅰ)水平变化及意义。方法应用放射免疫分析测定了40例新生儿缺氧缺血性脑病急性期与恢复期血清INS、LEP和IGF-I的水平并与30名正常新生儿作比较。结果新生儿窒息时HIE组与正常对照组比较血清IGF-Ⅰ下降,瘦素升高,且差异有统计学意义(P<0.01),HIE组患儿急性期血中IGF-Ⅰ下降,恢复期有所回升,差异有统计学意义(P<0.01),重度HIE组急性期与恢复期瘦素比较差异有统计学意义(P<0.05),血浆INS水平与对照组差异无统计学意义(P>0.05)。结论 IGF-Ⅰ在中枢神经系统中起重要保护作用,INS、LEP参与IGF-Ⅰ的代谢过程,并与新生儿缺氧缺血性脑病病理过程密切相关。
Objective To investigate the changes of serum insulin (INS), leptin (LEP) and insulin-like growth factor-I (IGF-I) levels in neonates with hypoxic-ischemic encephalopathy (HIE) Methods Serum levels of INS, LEP and IGF-I in 40 neonates with hypoxic-ischemic encephalopathy were measured by radioimmunoassay and compared with 30 normal neonates. Results Serum IGF-Ⅰ levels and leptin levels in neonatal asphyxia group were significantly lower than those in normal control group (P <0.01). The levels of IGF-Ⅰ in acute phase of HIE group were decreased, (P <0.01). There was significant difference in leptin between acute and recovery stages in severe HIE group (P <0.05), but there was no significant difference between plasma INS level and control group (P > 0.05). Conclusion IGF-Ⅰ plays an important protective role in central nervous system. INS and LEP participate in the metabolism of IGF-Ⅰ and are closely related to the pathological process of neonatal hypoxic-ischemic encephalopathy.