The Prognostic And Evaluative Value Of GFAP And Protein S100B In Hypoxic-Ischemic Encephalopathy

Objective:Hypoxic Ischemic Encephalopathy(HIE)is a common disease in newborns with high morbidity,disability and mortality.Severe HIE often results in growth retardation,Intellectual disability,behavioral disorder,epilepsy and even cerebral palsy in children,causing great harm to patients families and society.With the development of medical level and neonatal intensive care unit(NICU),the focus of attention in recent years has been changed from reducing the mortality rate to the evaluation of early brain damage and prognosis,allowing for early clinical intervention and reducing the incidence of disability and sequelae,as well as improving the quality of life of patients.In the current study,we analyzed the serum concentration of glial fibrillary acidic protein(GFAP)and S100B protein,the changes in serum concentration in patients with different stages of HIE,their differences and clinical significance to provide clinical evidence for HIE and its prognosis assessment.Methods:1.Objectives:180 children with HIE diagnosed in our hospital from January to December 2016 were selected as observation group.According to the clinical manifestations such as birth score,postnatal consciousness disorder,dystonia,abnormal primitive reflex,elevated intracranial pressure and brainstem symptoms,they were divided into three groups(n=60 for each group):mild,moderate and severe HIE group.Those with other diseases and those unable to follow up for one year were excluded.Sixty normal newborns in the same period were selected as control group.2.Data-collection:each group of the children with HIE were collected on the 1st,3rd and 7th day after birth,while serum samples in the control group were collected on the 1st and 3rd day after birth.Serum S100B protein and GFAP were measured by ELISA.The children with HIE were followed up by electronic information contact and regular outpatient consultation.They were followed up once in 1 to 2 months,and were followed up to 1 year old mainly for hearing and visual screening and intelligent test.Intelligent was assessed by Gesell Development Scale.The patients with DQ<85 were sequelae group,and those with DQ ≥ 85 had normal prognosis were non-sequelae group.Results:1.The concentration of serum S100B protein in the observation group was higher than that in the control group on the first day after birth(p<0.01).and the concentration of serum GFAP in the observation group was higher than that in the control group on the third day after birth(p<0.01).The serum levels of S100B protein and GFAP in the first,third and seventh day after birth in different observation groups were higher in the severe group than in the moderate group,higher in the moderate group than in the mild group.and higher in the sequelae group than in the non-sequelae group(p<0.01).2.The serum levels of S100B protein and GFAP in the non-sequelae group were lower than those in the sequelae group on the 1st,3rd and 7th day after birth(p<0.01).Conclusion:1.The serum levels of S100B protein and GFAP in HIE children were higher than those in normal newborns,and the more serious the condition was,the higher the concentration of both.The serum levels of S100B protein and GFAP in children with sequelae were higher than those in children without sequelae.Therefore,dynamic monitoring of serum levels of S100B protein and GFAP is of great significance for early evaluation of the condition of HIE children and judging the severity of prognosis.2.The higher the concentration of serum S100B protein and GFAP,the greater the possibility of sequelae,which can provide evidence for the prognosis of children with HIE.