Imam S S, Gad G I, Atef S H, Shawky M A
Department of Pediatric, Ain Shams University, Abbasiah, Cairo, Egypt.
Pak J Biol Sci. 2009 Dec 1;12(23):1498-504. doi: 10.3923/pjbs.2009.1498.1504.
This prospective case control study was designed to evaluate cord blood brain derived neurotrophic factor level in full term newborns with perinatal asphyxia as a marker of central nervous system insult and predictor of severity of hypoxic ischemic encephalopathy, with follow up of its level during the reperfusion phase. The study included twenty fullterm neonates with perinatal asphyxia (cases) and twenty controls. Cord blood samples were obtained at birth and peripheral blood samples at 72 h postnatal from cases only. Plasma brain derived neurotrophic factor level was measured using enzyme linked immunosorbent assay. The clinical severity of encephalopathy was graded based on Sarnat and Sarnat staging. Cord Plasma brain derived neurotrophic factor level was significantly increased among cases compared to controls. Among cases, brain derived neurotrophic factor level at delivery and after 72 h significantly correlated with the severity of encephalopathy according to Sarnat staging being higher as severity increases. Brain derived neurotrophic factor level significantly increased after 72 h of life compared to its level at delivery among cases. Brain derived neurotrophic factor levels at delivery and at 72 h postnatal were predictors of severe Sarnat stage and poor outcome. We concluded that brain derived neurotrophic factor level as a marker of central nervous system insult is increased in full term newborns with perinatal asphyxia. It can serve as an indicator for the severity of encephalopathy and adverse outcomes.
这项前瞻性病例对照研究旨在评估足月围产期窒息新生儿的脐带血脑源性神经营养因子水平，作为中枢神经系统损伤的标志物和缺氧缺血性脑病严重程度的预测指标，并在再灌注阶段对其水平进行随访。该研究纳入了20名足月围产期窒息新生儿（病例组）和20名对照组。仅在病例组出生时采集脐带血样本，出生后72小时采集外周血样本。采用酶联免疫吸附测定法测量血浆脑源性神经营养因子水平。根据萨纳特和萨纳特分期对脑病的临床严重程度进行分级。与对照组相比，病例组脐带血浆脑源性神经营养因子水平显著升高。在病例组中，根据萨纳特分期，分娩时和72小时后的脑源性神经营养因子水平与脑病严重程度显著相关，严重程度越高，水平越高。与分娩时相比，病例组出生72小时后脑源性神经营养因子水平显著升高。分娩时和出生后72小时的脑源性神经营养因子水平是萨纳特严重分期和不良预后的预测指标。我们得出结论，脑源性神经营养因子水平作为中枢神经系统损伤的标志物，在足月围产期窒息新生儿中升高。它可作为脑病严重程度和不良结局的指标。
