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目的:探究新生儿缺氧缺血性脑病(HIE)血清胰岛素生长因子1(IGF-I)和生长激素(GH)水平与患儿病情程度之间的关系。方法:选取2005年6月~2014年10月期间我院产科出生的HIE患儿49例为研究对象(研究组),选取同期健康新生儿50例作为对照组,分别于出生后72小时内和26~28天测量IGF-I和GH水平,HIE组患儿在急性期和恢复期做神经行为测定(NBNA),分析各个指标之间的关系。结果:新生儿血清IGF-I水平在72 h内和26-28 d四组间比较,其中重度组低于其他三组,中度组低于轻度和对照组,差异均有统计学意义(P<0.05);新生儿血清GH水平在72 h内和26~28 d四组间比较,差异无统计学意义(P>0.5);新生儿血清IGF-I与GH不存在显著相关性(r=0.193,P>0.05);HIE组患儿IGF-I水平与NBNA分值在急性期和恢复期均存在显著正相关(r=0.315,P<0.05;r=0.249,P<0.05),而GH与NBNA分值在急性期和恢复期均不存在显著的相关性(r=0.210,P>0.05)。结论:新生儿IGF-I水平不仅可以预测HIE患儿的病情,且可以影响新生儿HIE的预后情况。
Objective: To investigate the relationship between serum insulin-like growth factor-1 (IGF-I) and growth hormone (GH) levels and the severity of illness in neonates with hypoxic-ischemic encephalopathy (HIE). Methods: Forty-nine HIE children born in obstetrics department of our hospital from June 2005 to October 2014 were selected as study group (study group), 50 healthy newborns were selected as control group, IGF-I and GH levels were measured at 26 to 28 days. Neonatal behavioral assessment (NBNA) was performed in children with HIE during acute and convalescent periods to analyze the relationship between the various indicators. Results: The levels of serum IGF-I in neonates were lower than those in the other three groups within 72 h and 26-28 d, the moderate group was lower than the mild group and the control group, the differences were statistically significant ( P <0.05). There was no significant difference in neonatal serum GH levels between 72 h and 26-28 d (P> 0.5). There was no significant correlation between neonatal serum IGF-I and GH = 0.193, P> 0.05). There was a significant positive correlation between IGF-I level and NBNA score in acute stage and convalescent stage in children with HIE (r = 0.315, P <0.05; r = 0.249, P <0.05) There was no significant correlation between GH and NBNA scores in both acute phase and convalescent phase (r = 0.210, P> 0.05). Conclusion: Neonatal IGF-I level can not only predict the condition of children with HIE, but also affect the prognosis of neonates with HIE.