ABSTRACT
Objective To explore the relationship between urinary activin A and neonatal hypoxic-ischemic encephalopathy(HIE).Methods 50 full-term neonatal with HIE were selected as the observation group,48 normal full-term neonatal in the same period were selected as the normal control group randomly.Within 7 days after birth,the observation group was divided into the group of 30 patients with mild HIE and the group of 20 patients with moderate and severe HIE,according to diagnostic criteria and clinical grading of neonatal HIE.The levels of urinary activin A in two groups after birth at different time(2,12,24,48,72h)was determined by using ELISA method.Results The levels of urinary activin A in moderate and severe HIE group was significantly higher than than in the normal control group(P＜0.01)and mild HIE group(P＜0.01);The levels of urinary activin A in the normal control group and mild HIE group showed no significant differences(P＞0.05).Urinary activin A level＞70 ng/L for the critical value to determine the occurrence of moderate and severe HIE,the sensitivity and specificity of 2 h urinary activin A levels were separately 86％ and 99％;The sensitivity and specificity of 12～72 h urinary activin A levels were separately 100％ and 98％.Conclusion The correlation between the level of urinary activin A and the severity of HIE was positive,the level of urinary activin A had a high degree of sensitivity and specificity for determine the incidence of moderate and severe HIE,it provided an important basis for diagnosis of moderate and severe HIE.
ABSTRACT
Objective To investigate the risk factors of cerebral palsy in newborns with periventricular leukomalacia(PVL).Methods Sixty-one infants with sequela of cerebral palsy among 806 neonates born at the Second People'S Hospital of Liaocheng,Shandong,China,during December 2000 to November 2005 were studied for its etiology.Diagnosis of cerebral palsy in 26 of the 61 infants was established by type B ultrasonic scanning or magnetic resonance imaging(MRI)for the head at least twice and excluded of other diseases.Thirty-five infants without PVL hospitalized at the same hospital were enrolled as control group during the same period.Logistic regression analysis was performed for the risk factors of PVL. Results Twenty-six infants were diagnosed as PVL.accounting for 42.6％of those with cerebral palsy.Main high-risk factors of PVL included severe asphyxia(x3),low gestational age(x1),intraventricular hemorrhage(x14)and low blood pressure(x8),with odds ratios of 2.843,3.575,3.268 and 1.947,respectively,and a fitted regression model as logistic(P)=β0+0.7952 x3-1.428x1-1.328 x14+0.8256x8.Pregnant hypertension,neonate respiratory distress syndrome(NRDS),and intrauterine infection could also affect occurrence of PVL,all with statistical significance(P＜0.05).Conclusion PVL is one of main causes of cerebral palsy,with severe asphyxia,low gestational age,intraventricular hemorrhage and low blood pressure as main high-risk factors.