OBJECTIVE: Energy failure of cerebral cells was regarded as one of the main mechanisms that led to hypoxic-ischemic encephalopathy(HIE) in the asphyxiated newborn. Few reports have discussed how to assess the relationship between energy failure and brain damage. The aim of the study is to explore the relationship between 3' , 5' -cyclin adenosine monophosphate (cAMP) and hypoxic brain damage by measuring the cAMP level in cerebrospinal fluid (CSF) of the asphyxiated newborn. METHODS: Thirty six full-term newborns were divided into three groups; moderate-severe HIE group (n= 12) , mild HIE group (n= 13) and non-HIE group (control group, n= 11). The levels of cAMP in CSF and plasma were measured by RIA between 36 hs and 72 hs after birth. The discharged newboms were followed up when they were 6 and 12 months old for measuring the mental development index (MDI) and psychomotor development index (PDI) by the Bayley Scales of Infant Development (BSID). RESULTS: The CSF cAMP level in the moderate-severe HIE group was (8.60±2.41) nmol/L, significantly lower than that of the mild HIE group [(14.83±2.84) nmol/L] and the control group [(24.43±2.39) nmol/L] (both P <0.01). There was a significant difference in the CSF cAMP level between the mild HIE group and control group ( P <0.01). The cAMP level in plasma in the moderate-severe group was the lowest, and that in the control group was the highest, but no significant difference was found between the mild HIE group and the control group. The results which were followed up showed that MDI and FDI of the moderate- severe HIE group were the lowest (84.79 ±13.34, 83.50±13.28, respectively); those of the mild HIE group were the second lowest (102.19±7.02, 99.94±9.08, respectively) and those of the control group were the highest (116.63±12.08, 116.69110.87, respectively). There were significant differences among the three groups ( P <0.01). ThecAMP level in CSF was significantly positively correlated to PDI and MDI ( r = 0.68, r =0.75,respectively, both P <0.01). CONCLUSIONS: There is a significant correlation between the cAMP level in CSF and hypoxic-ischamic brain damage. So the cAMP level in CSF following neonatal asphyxia might be used as one of the sensitive markers in evaluating the severity of brain damage at an early stage and predicting the future outcome."/>
脑脊液中cAMP浓度与新生儿窒息后脑损伤关系的临床研究
Abstract：OBJECTIVE: Energy failure of cerebral cells was regarded as one of the main mechanisms that led to hypoxic-ischemic encephalopathy(HIE) in the asphyxiated newborn. Few reports have discussed how to assess the relationship between energy failure and brain damage. The aim of the study is to explore the relationship between 3' , 5' -cyclin adenosine monophosphate (cAMP) and hypoxic brain damage by measuring the cAMP level in cerebrospinal fluid (CSF) of the asphyxiated newborn. METHODS: Thirty six full-term newborns were divided into three groups; moderate-severe HIE group (n= 12) , mild HIE group (n= 13) and non-HIE group (control group, n= 11). The levels of cAMP in CSF and plasma were measured by RIA between 36 hs and 72 hs after birth. The discharged newboms were followed up when they were 6 and 12 months old for measuring the mental development index (MDI) and psychomotor development index (PDI) by the Bayley Scales of Infant Development (BSID). RESULTS: The CSF cAMP level in the moderate-severe HIE group was (8.60±2.41) nmol/L, significantly lower than that of the mild HIE group [(14.83±2.84) nmol/L] and the control group [(24.43±2.39) nmol/L] (both P <0.01). There was a significant difference in the CSF cAMP level between the mild HIE group and control group ( P <0.01). The cAMP level in plasma in the moderate-severe group was the lowest, and that in the control group was the highest, but no significant difference was found between the mild HIE group and the control group. The results which were followed up showed that MDI and FDI of the moderate- severe HIE group were the lowest (84.79 ±13.34, 83.50±13.28, respectively); those of the mild HIE group were the second lowest (102.19±7.02, 99.94±9.08, respectively) and those of the control group were the highest (116.63±12.08, 116.69110.87, respectively). There were significant differences among the three groups ( P <0.01). ThecAMP level in CSF was significantly positively correlated to PDI and MDI ( r = 0.68, r =0.75,respectively, both P <0.01). CONCLUSIONS: There is a significant correlation between the cAMP level in CSF and hypoxic-ischamic brain damage. So the cAMP level in CSF following neonatal asphyxia might be used as one of the sensitive markers in evaluating the severity of brain damage at an early stage and predicting the future outcome.
LIU Han-Chu,CHANG Li-Wen,CHEN Ye et al. Relationship Between the cAMP Level in Cerebrospinal Fluid and Hypoxic Brain Damage Following Asphyxia in Newborns[J]. CJCP, 2003, 5(5): 431-434.
