A Clinical Study On Changes Of Serum Enzymes And Craniocerebral CT In Neonates With Perinatal Asphyxia During Different Gestational Age

Objectives To investigate the effects on neonates caused of perinatal asphyxia during different gestational age.Methods48neonates with perinatal asphyxia(experimental group) and30normal cases (control group) were involved.The serum enzymes,include Aspertate aminotransferase (AST), lactate dehydrogenase (LDH), a-hydroxybutyric acid dehydrogenase (a-HBDH), were detected within24h after birth in both groups.A contrast analysis of results was performed between the two groups. Skull-CT was done in experimental group on one day from postnatal4to7days.Non-perinatal asphyxia factors which due to changes in activities of serum enzymes were excluded in both groups. Skull-CT examination by the64row spiral CT scanner performed in experimental group on one day from postnatal4to7days. The method was to scan continuously upwards from the baseline in5～10mm of each layer.Results:The activities of serum enzymes increased in experimental group compared with that in control group. The differences in the two groups were significant for term infants (P<0.05) and not significant for preterm infants (P>0.05). The result of Skull-CT examination showed, Hypoxic-ischemic encephalopathy existed in a majority of experimental group except for3term infants which were almost normal. There was Low density shadow of different degrees existed in cerebral parenchyma. A part of cases were combined with cerebral hemorrhage,most of which was subarachnoid hemorrhage. The low density shadow was mainly located in cerebral cortex and subcortical white matter for term infants while in periventricular white matter for preterm infants. Low density shadow located in cortical and subcortical white matter(CT value<18Hu) in all21cases of term infants in experimental group, mainly in the bilateral frontal, temporal, parietal and occipital lobe. Periventricular white matter was involved in6cases. There was ventriculomegaly in one case and as subarachnoid hemorrhage in5cases as complications. Low density shadow located in Periventricular white matter (CT value<14Hu) in all24cases of preterm infants in experimental group, including diffuse lower density of cerebral parenchyma in5cases, subarachnoid hemorrhage in9cases and ventricular hemorrhage in2cases as complications.Conclusions The effects on neonates caused of perinatal asphyxia exist in gestational age difference. Changes of serum enzyme activities can present different degrees of asphyxia for term infants. There’s no obvious relation between serum enzyme activities and degrees of asphyxia for for preterm infants. Asphyxia causes different pathological lesions in he different development stages of brain tissue. Cerebral injury was mainly located in cerebral cortex and subcortical white matter for term infants while in periventricular white matter for preterm infants.