Department of Neonatology, Handan Maternal and Child Care Centers, Handan 056002, Hebei Province, PR China; Department of Neonatal pathology, Handan Maternal and Child Care Centers, Handan 056002, Hebei Province, PR China.
Department of Neonatology, Handan Maternal and Child Care Centers, Handan 056002, Hebei Province, PR China.
Clin Chim Acta. 2015 Oct 23;450:282-97. doi: 10.1016/j.cca.2015.08.021. Epub 2015 Aug 28.
Neonatal hypoxic ischemic encephalopathy (HIE) is a common disease caused by perinatal asphyxia, a major cause of neonatal death, neurological behavior, and long-term disability. Currently, the diagnosis and prognosis of neonatal HIE are based on nervous system clinical manifestations, imaging and electrophysiological examination. These take time and late diagnosis allows brain injury to occur in newborns, so that infants of many brain injury missed the best treatment time, left with varying degrees of neurological sequelae. The use of biomarkers to monitor brain injury and evaluate neuroprotective effects might allow the early intervention and treatment of neonatal HIE to reduce mortality rates. This study reviewed the mechanism of neonatal hypoxic ischemic encephalopathy in relation to numerous brain-related biomarkers including NSE, S-100β, GFAP, UCH-L1, Tau protein, miRNA, LDH, and CK-BB. In early diagnosis of neonatal HIE, S-100β and activin A seems to be better biomarkers. Biomarkers with the greatest potential to predict long-term neurologic handicap of neonates with HIE are GFAP and UCH-L1 and when combined with other markers or brain imaging can increase the detection rate of HIE. Tau protein is a unique biological component of nervous tissues, and might have value for neonatal HIE diagnosis. Combination of more than two biological markers should be a future research direction.
新生儿缺氧缺血性脑病(HIE)是一种由围产期窒息引起的常见疾病,是新生儿死亡、神经行为和长期残疾的主要原因。目前,新生儿 HIE 的诊断和预后主要基于神经系统临床表现、影像学和电生理学检查。这些需要时间,而且延迟诊断会导致新生儿脑损伤,使许多脑损伤的婴儿错过最佳治疗时间,留下不同程度的神经后遗症。使用生物标志物监测脑损伤和评估神经保护作用可能有助于早期干预和治疗新生儿 HIE,降低死亡率。本研究综述了与许多与脑相关的生物标志物(包括 NSE、S-100β、GFAP、UCH-L1、Tau 蛋白、miRNA、LDH 和 CK-BB)有关的新生儿缺氧缺血性脑病的发生机制。在新生儿 HIE 的早期诊断中,S-100β 和激活素 A 似乎是更好的生物标志物。具有最大潜力预测 HIE 新生儿长期神经功能障碍的生物标志物是 GFAP 和 UCH-L1,当与其他标志物或脑成像结合使用时,可提高 HIE 的检出率。Tau 蛋白是神经组织的独特生物成分,对新生儿 HIE 的诊断可能具有价值。联合使用两种以上的生物标志物应该是未来的研究方向。