The Clinical Siglificance Of SICAM-1,IGF-1 Concentrations In Serum,CSF In Newborns With HIE

Objective The research was aimed to study the change of solubility intarcelluar adhesion molecules-1(sICAM-1),insulin-like growth factors (IGFs)in serum,cerebrospinal fluid(CSF)of newborns with hypoxic-ischemic encephalopathy (HIE) and make out the relationship between the concentration of sICAM-1,IGF-1 in HIE patients and the degree of brain injury.Methods 42 cases of term infants, gestational age from 37 weeks to 41+ weeks and birth weight 2300g-4250g , receive from NOV 2006 to NOV 2007 in the neonatal intensive care unit of Second Affiliated Hospital of Nanhua University, Central Hospital,Maternal and Child Health Hospital and First Affiliated Hospital of Nanhua University in Hengyang, were classified into 3 degrees(mild degree, moderate degree and severe degree) as the HIE group. 32 cases of term infants received at the same time as the normal control group. All the HIE group infants received same treatment. All newborns in HIE group were given behavioral neurological assessment (NBNA)and the head computerized tomography(CT) examination within 3 days(acute stage), and they examined again at the age of 10 day(sconvalescence stage). Using enzyme linked immunosorbent assay(ELISA)technology, the serum and CSF concentration of sICAM-1,IGF-1 were detected within 3 days and at the age of 10 days detected the serum concentration of sICAM-1,IGF-1. All the consequence were compared with those of normal control at age of 3 days .Results1 The results showed that the concentration of sICAM-1 in serum at acute stage were significantly different between the HIE group and the normal control group(P<0.05), the serum concentration of sICAM-1 in severe HIE group were much higher than those of other HIE groups, the differences were significant(P<0.05). Concentration of sICAM-1 correlated with the head injury degree of HIE infants.2 The concentration of IGF-1 in serum at acute stage were significantly different between the HIE group and the normal control group(P<0.05). The serum concentration of IGF-1 in severe HIE group were much lower than those of other HIE groups, the differences were significant(P<0.05). Concentration of IGF-1 also correlated with the head injury degree of HIE infants.3 The serum concentration of sICAM-1 at acute stage were higher than those at convalescence stage, but it still higher than those of normal control group, the differences were significant(P<0.05); The serum concentration of IGF-1 at acute stage were lower than those at convalescence stage, it still lower than those of normal control group, the differences were also significant(P<0.05).4 Compared with CSF, serum concentration of sICAM-1 at acute stage was slightly lower than that in CSF , there were not significantly difference between the two group(P>0.05); the concentration of IGF-1 in serum was higher than those in CSF, the difference were significant(P<0.05)between the two groups.5 The dynamic changes of sICAM-1 in serum was opposite with those of IGF-1 and they were negative correlated(r=-0.63424 , P<0.05).Conclusion The concentration of sICAM-1 in serum and CSF was increased at the acute stage and the concentration of IGF-1 in serum and CSF was decreased, which was correlated with severity of HIE. sICAM-1 and IGF-1 were reliable biochemical markers for early estimates of hypoxic-ischemic brain damage and might have great value to judging the stage of HIE correctly.