The Prospective Clinical Study For Screening The Infants With The High Risk Factor For Cerebral Palsy By Measuring The Lever Of Interleukin-6 And Neuron-specificenolase In Premature Serum

OBJECTIVE The purpose of this prospective clinical study was to explore the association of neonatal damage and interleukin-6(IL-6),neuron-specifice -nolase(NSE)concentration in umbilical cord plasma, serum within 4 days of life in premature. The earlier period estimate the risk, which the infants get the cerebral palsy. To evaluate the value of these two biological markers for screening the infant with the high risk factor for cerebral palsy (CP) so as to be diagnosed earlier as we can. METHODS Prospective clinical study. Umbilical cord plasma was collected from 32 cases ≤35 weeks and /or birth weight ＜2000g preterm births, vein serum was collected from 30 within 4 days of life preterm births, umbilical cord plasma of term newborns matched control for 20 examples. IL-6 was measured by RIA methods. NSE was measured by ELISA methods. And we followed these premature until being diagnosed cerebral palsy or death. The normal children were followed until 3 years old. Statistical analysis was performed with one-way ANOVA and rank sum test by SAS 6.12 and receiver operating characteristic curve analysis by SPSS. RESULTS 1. There were no difference between umbilical cord plasma group and vein serum group in gestational age and birth weight, the P value is respectively for 0.1464 and 0.1210. 2. There was highly significant expression of IL-6 level in both umbilical cord plasma and vein serum(P＝0.0289), but there were no difference between them. 3. The NSE level in vein serum group were higher than umbilical cord plasma group, which higher than matched control group (P＝0.0001). 4. With the following result, of the 62 preterm neonates included in this study, 3 died before age 1 month and 12 (19.35%) had cerebral palsy. Among them, 2 died and 5 had cerebral palsy in umbilical cord plasma group, 1 died and 7 had cerebral palsy. 5.The children with cerebral palsy had significantly higher median concentrations of IL-6 in serum and NSE in umbilical cord, in vein serum than those without cerebral palsy; the P value is respectively for 0.0140, 0.0255 and 0.0095. 6.When IL-6 lever ≥ 305.03 pg/ml were used as a criteria to prompt the high risk of cerebral palsy ,the sensitivity was 73.3% and the specificity was 61.7%;When NSE lever in umbilical cord plasma group ≥8.1175 ug /l, the sensitivity was100% and the specificity was 64%;When NSE lever in vein serum group≥ 15.00 ug /l, the sensitivity was 87.5% and the specificity was 70%. CONCLUSION IL-6 is associated with the brain injure that the acute and chronic intrauterine infection led to, but NSE is associated with acute brain damage during perinatal period, we can use the umbilical cord plasma in the newborns with the high risk factor for CP to exam IL-6 and NSE lever .With IL-6 lever≥305.03 pgs/ ml, NSE lever≥15 ug/l used as a monitoring criteria , there were the higher sensitivity and the specificity .