观察新生儿缺氧缺血性脑病(HIE)血清、脑脊液中胰岛素样生长因子-Ⅰ(IGF-Ⅰ)水平的变化及相关性，探讨IGF-Ⅰ在新生儿HIE发病机制及预后中的作用。

用放射免疫法(RIA)检测41例HIE组新生儿生后12 h〜24 h及10 d〜12 d血清、脑脊液及10例正常足月新生儿(对照组)血清中IGF-Ⅰ的水平变化。

①生后12 h〜24 h，轻、中、重度HIE组血清IGF-Ⅰ的水平分别为(32.94± 8. 43)ng/ml，(22.56±5. 51)ng/ml,(15. 77±3. 60)ng/ml，明显低于对照组(79. 28±13. 28)ng/ml(P< 0. 01)；且HIE程度越重，IGF-Ⅰ的水平越低(P<0. 05)。②生后10d〜12d，轻、中度HIE组及重度HIE无症状组血清中IGF-Ⅰ 的水平分别为(67.22±21. 52)ng/ml,(68. 54±22. 88)ng/ml，(52. 58±14.11)ng/ml，分别较各组生后12 h〜24 h的水平增高(P<0. 01)，仍低于对照组(P<0. 01)，其脑脊液中的水平分别为(6.18±0. 87)ng/ml,(5. 74±0. 94)ng/ml，(5.08±0. 87)ng/ml，也较生后12 h〜24 h时的水平，分别为(4.43±1. 16)ng/ml,(3. 19±0. 84)ng/ml,(1. 97±0. 45)ng/ml均明显增高(P<0. 01)；重度HIE有症状组血清和脑脊液的IGF-Ⅰ水平分别为(22.49±10. 58)ng/ml和(2.26±0. 70)ng/ml，虽较生后12 h 〜24 h增高，分别为(14.22±3. 37)ng/ml,(1. 87±0. 80)ng/ml，但差异无显著意义(P>0. 05)，然而却明显低于其他各组的水平(P<0. 01)。③HIE组血清与脑脊液的IGF-Ⅰ水平呈正相关关系(r= 0. 84，P< 0.05)。

IGF-Ⅰ是一种重要的神经保护因子，其水平的改变可能与新生儿HIE的发生、发展及预后有关。

To investigate the changes and correlations of serum and cerebrospinal fluid(CSF)insulin-like growth factor-Ⅰ(IGF-Ⅰ)levels in neonates with hypoxic-ischemic encephalopathy(HIE)and to investigate its effects on HIE.

Both serum and CSF IGF-Ⅰ levels in 41 neonates with HIE and serum IGF-I levels in 10 normal neonates were measured by RIA at 12〜24 hrs and 10〜12 ds of life.

(1)During postnatal 12〜24 hrs, the serum IGF-I levels were 32. 94±8. 43ng/ml, 22. 56 ± 5. 51ng/ml and 15. 77 ± 3. 60ng/ml in mild, moderate and severe HIE groups, respectively, which were significantly lower than those in control group(79. 28±13. 28 ng/ml)(P<0. 01), and the more severe HIE was, the lower of IGF-I levels(P<0. 05).(2)During postnatal 10 to 12 days, the serum levels of IGF-Ⅰ in mild, moderate HIE and in severe HIE group who have no neurological symptoms or signs were significantly elevated compared with the HIE groups of postnatal 12 hrs -24hrs(P<0. 01)and there were no significant differences in the mild, moderate HIE(67. 22 ± 21. 52 ng/ml, 68.54±22. 88 ng/ml, respectively)and in severe HIE group who have no symptoms or signs(52. 58±14. 11 ng/ml)(P>0. 05). The CSF IGF-Ⅰ levels were 6. 18 ± 0. 87 ng/ml in mild, 5. 74 ± 0. 94 ng/ml in moderate and 5. 08 ± 0. 87 ng/ml in severe HIE group who have no neurological symptoms or signs respectively at postnatal 10-12days, which were significantly increased compared with their levels at postnatal 12〜24 hrs(4. 43±1. 16 ng/ml, 3.19 ± 0. 84ng/ml, 1.97 ± 0. 45ng/ml, respectively)(P<0. 01). However, there were no significant differences in serum and CSF IGF-Ⅰ levels between sever HIE group who have symptoms or signs at postnatal 10〜12ds and 12~24hrs groups(P>0. 05).(3)A positive correlation were shown between the serum and CSF IGF-Ⅰ levels in HIE groups(r= 0. 84, P<0. 05).

IGF-Ⅰ is an important neuroprotective factor and it's changes of levels in serum and in CSF might be associated with the pathogenesis and prognosis of neonatal HIE.