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目的探讨缺氧缺血性脑病(HIE)新生儿血清胶质纤维酸性蛋白(GFAP)的变化及其临床意义。方法选择2010—2011年本院新生儿科住院的足月HIE患儿为观察组,母婴同室的健康足月新生儿为对照组,采用酶联免疫吸附试验双抗体夹心法,对两组新生儿进行血清GFAP测定,并比较观察组和对照组、不同程度HIE组之间以及有后遗症组与无后遗症组新生儿血清GFAP水平有无差异。结果 HIE患儿发病第1、3、7天血清GFAP水平(μg/L)均高于对照组(P<0.01);发病第3天GFAP水平高于第7天[(2.46±1.98)比(1.52±1.19),P<0.05]。重度HIE组GFAP高于中度组和轻度组,中度组高于轻度组(P均<0.01);后遗症组GFAP含量明显高于无后遗症组[1天:(3.90±0.77)比(1.19±0.63),3天:(5.03±1.51)比(1.37±0.75),7天:(3.11±0.70)比(0.87±0.57),P<0.01]。结论 HIE新生儿血清GFAP含量增加与疾病严重程度及预后相关,检测HIE新生儿血清GFAP变化,有助于判定疾病严重程度及评估患儿的预后。
Objective To investigate the changes of serum glial fibrillary acidic protein (GFAP) in neonates with hypoxic-ischemic encephalopathy (HIE) and its clinical significance. Methods The full-term HIE children hospitalized in neonatal department of our hospital from 2010 to 2011 were selected as observation group and healthy full-term newborn infants in same room as control group. Enzyme-linked immunosorbent assay (ELISA) Serum GFAP was measured and compared between the observation group and the control group, with different levels of HIE group and the sequelae group and no sequelae group neonatal serum GFAP levels were there any difference. Results The serum levels of GFAP (μg / L) on the 1st, 3rd, 7th day were higher in the HIE children than those in the control group (P <0.01). GFAP level on the 3rd day of onset was higher than that on the 7th day [(2.46 ± 1.98) 1.52 ± 1.19), P <0.05]. The levels of GFAP in severe HIE group were higher than those in mild group and mild group (P <0.01), while those in sequelae group were significantly higher than those without sequelae [1 day: (3.90 ± 0.77) vs 1.19 ± 0.63), 3 days: (5.03 ± 1.51) vs (1.37 ± 0.75), 7 days: (3.11 ± 0.70) vs (0.87 ± 0.57), P <0.01]. Conclusion The increase of serum GFAP level in neonates with HIE is related to the severity and prognosis of HIE. Detecting the change of serum GFAP in neonates with HIE can help to determine the severity of the disease and evaluate the prognosis of children.