Umran Raid M R, Al-Tahir Mahir, Jagdish Desai, Chouthai Nitin
Department of Pediatrics, College of Medicine, University of Kufa, Al-Zahraa Teaching Hospital, Najaf Health Directorate, Najaf, Iraq.
Najaf Health Directorate, Al-Zahraa Teaching Hospital, Najaf, Iraq.
Am J Perinatol. 2016 Jun;33(7):640-5. doi: 10.1055/s-0036-1571319. Epub 2016 Feb 5.
Objective This study aims to evaluate the correlation of changes in serum insulin-like growth factor-1 (IGF-1) levels with the clinical staging of hypoxic-ischemic encephalopathy (HIE) in term newborns. Study Design A prospective study of 29 newborns with HIE (stage I = 15, stage II + III = 14) and 28 healthy term newborns as the control group was performed in the neonatal intensive care unit. IGF-1 levels were obtained within 6 hours after birth from HIE and control groups and again on day 3 from HIE group. HIE was classified using the Sarnat staging I to III. Results IGF-1 levels were significantly lower in the HIE group than in the control group (p = 0.024). It was lower in the HIE stage II to III group compared with HIE stage I group at birth (p < 0.0001) and on day 3 (p = 0.009). The mean IGF-1 levels were significantly higher on day 3 than on day 1 among stage II to III HIE (p = 0.006) and it was inversely correlated with staging (R = - 0.475, p = 0.009). There was a significant correlation between IGF-1 levels and Apgar score at 5 (R = 0.39, p = 0.042) and 10 minutes (R = 0.38, p = 0.035). Conclusions IGF-1 was lower in HIE and inversely correlated with clinical staging. It was increased with clinical improvement in the subsequent days.
目的 本研究旨在评估足月儿缺氧缺血性脑病（HIE）患儿血清胰岛素样生长因子-1（IGF-1）水平变化与临床分期的相关性。研究设计 在新生儿重症监护病房对29例HIE新生儿（I期=15例，II + III期=14例）和28例健康足月儿作为对照组进行了一项前瞻性研究。在出生后6小时内从HIE组和对照组获取IGF-1水平，并在出生后第3天从HIE组再次获取。HIE采用Sarnat分期I至III期进行分类。结果 HIE组的IGF-1水平显著低于对照组（p = 0.024）。出生时（p < 0.0001）和第3天（p = 0.009），HIE II至III期组的IGF-1水平低于HIE I期组。在II至III期HIE中，第3天的平均IGF-1水平显著高于第1天（p = 0.006），且与分期呈负相关（R = - 0.475，p = 0.009）。IGF-1水平与出生后5分钟（R = 0.39，p = 0.042）和10分钟（R = 0.38，p = 0.035）的阿氏评分之间存在显著相关性。结论 HIE患儿的IGF-1水平较低，且与临床分期呈负相关。在随后的几天中，随着临床症状改善其水平升高。
