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目的探讨新生儿血清转化生长因子-β1(TGF-β1)和脑型肌酸激酶(CK-BB)在缺氧缺血性脑病(HIE)中的变化及临床意义。方法选择足月HIE患儿为观察组,健康或生理性黄疸、咽下综合征的足月儿为对照组,分别在生后第1、3、7天检测TGF-β1浓度和CK-BB活性,分析两项指标与病情严重程度及预后的关系。结果对照组第3天血清TGF-β1浓度[(26.4±13.5)μg/L]高于轻度[(21.9±13.1)μg/L]和中重度HIE组[(14.0±10.1)μg/L],第1天CK-BB活性[(36.7±23.2)U/L]低于轻度[(80.5±36.3)U/L]和中重度HIE组[(130.4±210.4)U/L],差异有统计学意义(P均<0.05);HIE组患儿血清中TGF-β1浓度和生后第14天NBNA评分呈正相关,CK-BB活性和生后第14天NBNA评分呈负相关(P均<0.05)。结论血清TGF-β1和CK-BB在HIE的早期诊断和预后评估中有一定参考价值,TGF-β1在缺氧缺血性脑损伤中起保护性作用。
Objective To investigate the changes of serum levels of transforming growth factor-β1 (TGF-β1) and brain-type creatine kinase (CK-BB) in neonates with hypoxic-ischemic encephalopathy (HIE) and their clinical significance. Methods The full-term HIE infants were selected as the observation group, healthy or physiological jaundice and full-term children with swallowing syndrome as the control group. The TGF-β1 concentration and CK-BB activity , Analyze the relationship between the two indicators and the severity and prognosis. Results The level of serum TGF-β1 in the control group [(26.4 ± 13.5) μg / L] on day 3 was significantly higher than that of mild HIE group (21.9 ± 13.1 μg / L) and [14.0 ± 10.1 μg / L] , The activity of CK-BB [(36.7 ± 23.2) U / L] on day 1 was lower than that of mild HIE group [(130.5 ± 210.4) U / L] (P <0.05). The serum TGF-β1 level in children with HIE was positively correlated with the NBNA score on the 14th day after birth, while the CK-BB activity was negatively correlated with the NBNA score on the 14th day after birth (all P < 0.05). Conclusion Serum TGF-β1 and CK-BB have some reference value in the early diagnosis and prognosis evaluation of HIE. TGF-β1 plays a protective role in hypoxic-ischemic brain damage.