Results of enzyme immunoassay of vasculoendothelial growth factor (VEGF) in blood serum in premature newborns with perinatal hypoxic damage to the central nervous system

G. Golosnaya, O. Krasnorutskaya, N. A. Ermolenko, D. A. Kholichev, A. V. Ogurtsov
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Abstract

Background. Vasculoendothelial growth factor (VEGF) is responsible for vascular remodeling, influences the formation of post-hypoxic structural changes in the newborn brain and is synergistically closely related to neurotrophic factors, being an inhibitor of apoptosis processes, which are important for lesions of the central nervous system in newborns of various types of gestational age, having suffered both acute asphyxia at birth and chronic intrauterine hypoxia. VEGF has been little studied in premature newborns, which are at high risk for the formation of intraventricular hemorrhage and periventricular leukomalacia.Aim. To study changes in the serum concentration of VEGF, its role in the pathogenesis of severe hypoxic-ischemic lesions of the central nervous system in premature newborns of various gestational ages, as well as to determine its prognostic significance for the formation of severe structural brain lesions.Materials and methods. We observed 120 children with a gestational age from 25 to 36 weeks. The children were divided into 4 groups according to changes to neurosonography data. Determination of protein level was carried out by enzyme immunoassay.Results and conclusion. With the formation of ischemic and combined (intraventricular hemorrhage and periventricular leukomalacia) forms of post-hypoxic changes in the brain in newborns, by 5–7th days of life the concentration of VEGF significantly decreased compared to the test on the 1st day of life, and by the 4th week of life it decreased in 4 times in case of combined lesions. VEGF cannot be used as a marker of damage in the acute period (up to 5 days of life), since its initial levels in the blood serum do not differ significantly from those in the control group. However, a decrease in its concentration by the end of the 1st week of life makes it possible to reliably predict the formation of post-hypoxic changes in the brain. A decrease in the level of VEGF in the blood serum in premature newborns with structural changes according to neurosonography by the 4th week of life coincides with the timing of the formation of gliotic changes, which significantly affects the developmental prognosis of the examined children
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围产期中枢神经系统缺氧性损伤的早产新生儿血清中血管内皮生长因子(VEGF)的酶免疫测定结果
背景。血管内皮生长因子(vascular endothelial growth factor, VEGF)负责血管重塑,影响新生儿大脑缺氧后结构变化的形成,并与神经营养因子协同密切相关,是细胞凋亡过程的抑制剂,在不同胎龄类型的新生儿中,无论是出生时急性窒息还是慢性宫内缺氧,其中枢神经系统病变都很重要。由于早产儿易发生脑室内出血和脑室周围白血病,VEGF在早产儿中的应用研究较少。研究不同胎龄早产儿血清VEGF浓度变化及其在中枢神经系统严重缺氧缺血性病变发病机制中的作用,并确定其对严重结构性脑病变形成的预后意义。材料和方法。我们观察了120名胎龄为25至36周的儿童。根据神经声像图变化情况将患儿分为4组。酶免疫法测定蛋白水平。结果与结论。随着新生儿脑缺氧后缺血性和合并(脑室内出血和脑室周围白质软化)变化形式的形成,在出生后5 - 7天,VEGF浓度较出生第1天的检测明显下降,在出生后第4周,VEGF浓度在合并病变的情况下下降了4倍。VEGF不能作为急性期(生命5天以内)损伤的标志,因为它在血清中的初始水平与对照组没有显著差异。然而,在生命第一周结束时,其浓度的下降使得可靠地预测大脑缺氧后变化的形成成为可能。神经超声检查结构改变的早产儿,在出生第4周时血清VEGF水平下降,与胶质细胞改变形成的时间一致,显著影响被检查儿童的发育预后
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