| Objective To observe the changes of blood neuropeptide Y(NPY) beta-endorphin(β-EP) and neuron-specific enalase (NSE) in neonates with hypoxic-ischemic encephalopathy(HIE) and explore the pathogenesis of brain injury in HIE, meanwhile, to explor therapeutic effects and possible mechanism of naloxone by detecting the changes of the markers before and after treatment respectively, and provide theoretical and practical basis for the treatment of HIE.Methods 34(n=34) neonates with moderate and severe degree HIE were randomly divided into two groups of routine(n=18) and naloxone treatments(n=16), and 14(n=14) heathy full-term neonates were served as normal control group. Based on the routine treatments ,the naloxone group was given naloxone injection for three days. The blood samples were collected before and after treatment respectively. The levels of NPY and β -EP were measured by radioimmunoassay(RIA).The levels of NSE were measured by enzyme-linked immunosorbent assay(ELISA), meanwhile, clinical manifestations were observed.Results 1 .The blood levels of NPY β-EP NSE in neonates with HIE before treatment were 174.23 ± 18.31ng/L 123.36 ± 16.42ng/L17.13 ± 2.08μg /L respectively, significantly higher than those in normalcontrol group (87.19 12.95ng/L 63.27 12.65ng/L , 10.34 1.57 g IL respectively, p<0.01). Correlation analysis showed that in neonates with HIE NPY correlated positively to NSE, EP correlated positively to NSE, and NPY correlated positively top-EP, the correlation coefficient was 0.655 0.720 0.347 respectively, p<0.05 2. The blood levels of NPY EP NSE in routine group after treatment were 124.72 13.91ng/L 89.05 13.27ng/L 14.13 2.08g IL respectively,obviously lower than those before treatment(174.83 18.28ng/L 121.72 17.49ng/L 16.97 2.49 g /L respectively, p<0.01)3. The blood levels of NPY EP NSE in naloxone group after treatment were 102.55 11.13ng/L 75.10 6.54ng/L 12.80 1.10/L respectively, obviously lower than those before treatment(l 73.55 18.92ng/L 125.20 15.48ng/L 17.31 1.55/L respectively, p<0.01).4. After treatment the blood levels of NPY , EP NSE in naloxone group were significantly lower than those in routine group. The average value of decreased blood NPY EP NSE in naloxone group was 71.00 11.48ng/L , 50.10 12.25ng/L , 4.51 0.74 g /L respectively, significantly statistical different as compared with routine group (50.11 8.02ng/L, 32.68 11.90ng/L 2.84?.93 g/L respectively, p<0.01).5. In naloxone group the lasting time of seizures, abnormal primitive reflexes, abnormal muscular tone and the hospitalization course was23.33 7.81h, 40.80 10.66h, 40.83 15.71h, 295.47 75.54h respectively, significantly shorter than those in routine group(42.80 13.1 Oh 58.25 18.26h, 60.33 12.12h, 354.24 76.71h respectively, p<0.01).Conclusion 1. The blood levels of NPY EP NPY in neonates with HIE were significantly higher than those in normal control group, and there were positive correlations among NPY EP NSE. The results suggested that NPY EP were jointly associated with the pathophysiological process of HIE, and might play an important role in the pathogenesis of HIE, which aggravated secondary brain injury and obviously increased the levels of NSE.2. Naloxone could significantly reduce the levels of NPY EP, block the course of secondary brain injury, obviously decrease the levels of NSE, promote the recovery of neuron function, improve the clinical manifestations, shorten the course, which show good protective and therapeutic effects of naloxone on HIE. |
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