Evaluation Of Some Biological Indicators In Birth Asphyxia And Hypoxic-ischemic Encephalopathy

ObjectiveTo study the basic characteristics of blood biological indicators in birth asphyxia and hypoxic-ischemic encephalopathy(HIE), and to identify the value of the markers in early diagnosis and risk stratification.MethodsThis study recruited 47 full-term infants with perinatal asphyxia(33 infants with no HIE and 14 infants with HIE) and 27 healthy matched controls. Peripheral blood samples were collected with in 24 h after birth. Several biological indicators were examined by Fully automatic biochemical analyzer and automated blood analyzer, including myocardial enzymes(a-HBDH, CK, CK-MB, LDH), liver function markers(ALT, AST), renal function markers(Cr, BUN), and immune function markers(PLT, CRP). At the same time, their peripheral blood were collected to segregate monocytes for detecting the expressions of NOD1 and NOD2 through real time PCR. The levels of the biomarkers were compared among the three groups(group A: healthy controls; group B: asphyxiated infants with no HIE; group C: asphyxiated infants with HIE). The receiver operating characteristics(ROC) curves were plotted to assess the diagnostic value of those indicators in neonatal asphyxia.Results1. Compared with healthy controls, all myocardial enzymes(a-HBDH, CK, CK-MB, LDH) raised in asphyxiated infants with or without HIE. And the levels of these markers in group C were significant higher than those in group B. For the diagnosis of newborn asphyxia, the performance of prediction, which is calculated by the area under ROC curve, was: CK-MB(0.859) > CK(0.840) > LDH(0.837) > a-HBDH(0.814). For the diagnosis of neonatal HIE, the performance of prediction was: a-HBDH(0.859) > CK-MB(0.833) > CK(0.818)> LDH(0.676).2. For renal function markers, Cr increased in asphyxia groups in contrast to healthy controls, and the levels of Cr in group C was significant higher than that in group B. The level of BUN group C was higher than control group, but there was no difference found between group A and group B. Furthermore, Cr was better than BUN in the performance of the diagnosis of newborn asphyxia and HIE.3. Compared with healthy controls, both ALT and AST increased in asphyxia groups. And the levels of these markers in group C were significant higher than those in group B. Moreover, AST was better than ALT in the performance of the diagnosis of newborn asphyxia and HIE.4. For immune function markers, NOD1 increased in asphyxiated infants compared with healthy controls, but there was no difference between group B and group C. The level of PLT in asphyxia groups was lower than that in control group, while no difference was found between group B and group C. Moreover, there was no difference found in NOD2 and CRP among the three groups. NOD1 was better than PLT in the performance of the diagnosis of newborn asphyxia.ConclusionsThe concentrations of serum a-HBDH、CK、CK-MB、ALT、AST、and Cr are increased in asphyxiated infants compared with healthy controls, which may be considered as useful predictive factors in newborn asphyxia.NOD1 was significant higher in asphyxiated neonates, which had good performance in the diagnosis of newborn asphyxia.