重度窒息足月儿脑组织特异性蛋白的动态改变

目的本研究旨在通过动态监测足月重度窒息新生儿血清脑源性神经营养因子(BDNF)、S-100B蛋白、Tau蛋白含量及变化,探讨其在窒息后脑损伤中的意义。方法 28例足月重度窒息患儿于生后24、72h、7天分别采集其血标本,20例健康足月新生儿取生后24h血标本,用酶联免疫吸附试验双抗体夹心法测定BDNF、S-100B蛋白、Tau蛋白浓度。结果足月窒息合并缺氧缺血脑病(HIE)新生儿,其血清BDNF和S-100B蛋白浓度于生后24h高于对照组,差异有统计学意义(P<0.05)。动态BDNF、S-100B蛋白检测显示,中-重度HIE患儿血清BDNF、S-100B蛋白于生后24h、7天龄高于轻度HIE组,差异有统计学意义(P<0.05)。研究还显示无论是轻度HIE组还是中-重度HIE组,动态监测组内3个不同时间段的BDNF、S-100B蛋白浓度,差异均无统计学意义(P>0.05)。监测不同程度HIE患儿Tau蛋白血清浓度各时间点差异均无统计学意义,与对照组比较也无统计学差异(P>0.05)。结论本研究提示足月窒息合并HIE新生儿,其血清BDNF、S-100B浓度于窒息的早期出现上调;窒息后神经元释放BDNF和S-100B数量与脑损伤程度的相关性较大,而随时间发生变化的程度相对较小。

Dynamic Changes of Cerebral Specific Proteins in Full Term Newborns with Severe Asphyxia

Objective To observe the dynamic changes of serum brain derived neurotrophic factor(BDNF),S-100B and Tau proteins levels in asphyxia neonates and to discuss their significance in brain damage.Methods Serum samples of 28 full term newborns diagnosed with severe asphyxia and 20 controls were obtained in the first 24 hours of life.Another serum samples were also taken respectively at 3 day and 7 days of life in asphyxia infants.The concentrations of BDNF,S-100B and Tau proteins were measured by the enzyme-linked immunosorbent assay method.Results Serum BDNF and proteins S-100B levels in asphyxia infants with hypoxic-ischemic encephalopathy(HIE) were significantly elevated in 24 hours after birth and their concentration were also significantly higher among patients with Mod-severe HIE as compared to those with mild HIE at 24 hour,and 7 days after asphyxia.Regardless of whether Mod-severe HIE or mild HIE,there were no significant difference of serum BDNF and proteins S-100B among the three different time periods.There was no difference in Tau protein level between asphyxia infants and control,also no difference between Mod-severe HIE group and mild HIE group.Conclusion BDNF and proteins S-100B are up-regulated early in asphyxiated neonates with HIE.The correlation between BDNF/S-100B concentration and encephalopathy grade is much greater than the correlation between BDNF/S-100B concentration and time after asphyxia.