Glial fibrillary acidic protein as a biomarker for neonatal hypoxic-ischemic encephalopathy treated with whole-body cooling

被引：139

作者：

Ennen, Christopher S. ^{[1
]}

Huisman, Thierry A. G. M. ^{[2
]}

Savage, William J. ^{[3
]}

Northington, Frances J. ^{[4
]}

Jennings, Jacky M. ^{[5
,7
]}

Everett, Allen D. ^{[6
]}

Graham, Ernest M. ^{[1
]}

机构：

[1] Johns Hopkins Univ, Sch Med, Dept Obstet & Gynecol, Div Maternal Fetal Med, Baltimore, MD 21205 USA

[2] Johns Hopkins Univ, Sch Med, Div Pediat Radiol, Dept Radiol & Radiol Sci, Baltimore, MD USA

[3] Johns Hopkins Univ, Sch Med, Dept Pathol Transfus Med, Baltimore, MD USA

[4] Johns Hopkins Univ, Sch Med, Dept Pediat, Div Neonatol, Baltimore, MD 21205 USA

[5] Johns Hopkins Univ, Sch Med, Dept Pediat, Div Gen Pediat & Adolescent Med, Baltimore, MD 21205 USA

[6] Johns Hopkins Univ, Sch Med, Dept Pediat, Div Cardiol, Baltimore, MD 21205 USA

[7] Johns Hopkins Univ, Dept Epidemiol, Bloomberg Sch Publ Hlth, Sch Med, Baltimore, MD USA

来源：

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY | 2011年 / 205卷 / 03期

关键词：

fetal acidosis; glial fibrillary acidic protein; hypoxicischemic encephalopathy; neonatal seizures; whole-body cooling; TRAUMATIC BRAIN-INJURY; SYSTEMIC HYPOTHERMIA; RANDOMIZED-TRIAL; CARDIAC-ARREST; TERM INFANTS; SERUM; ASSOCIATION; LESIONS; MRI; AGE;

D O I：

10.1016/j.ajog.2011.06.025

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

OBJECTIVE: Glial fibrillary acidic protein (GFAP) is specific to astrocytes in the central nervous system. We hypothesized that serum GFAP would be increased in neonates with hypoxic-ischemic encephalopathy (HIE) treated with whole-body cooling. STUDY DESIGN: We measured GFAP at birth and daily for up to 7 days for neonates in the intensive care unit. We compared neonates with HIE treated with whole-body cooling to gestational age-matched controls without neurological injury and neonates with HIE by brain abnormalities on magnetic resonance imaging (MRI). RESULTS: Neonates with HIE had increased GFAP levels compared with controls. Neonates with HIE and abnormal brain imaging had elevated GFAP levels compared with neonates with HIE and normal imaging. CONCLUSION: Serum GFAP levels during the first week of life were increased in neonates with HIE and were predictive of brain injury on MRI. Biomarkers such as GFAP could help triage neonates with HIE to treatment, measure treatment efficacy, and provide prognostic information.

引用

页数：7

共 32 条

[1]

[Anonymous], 2003, Neonatal encephalopathy and cerebral palsy, P73

[2] Neurological and perceptual-motor outcome at 5-6 years of age in children with neonatal encephalopathy: Relationship with neonatal brain MRI [J].

Barnett, A ;

Mercuri, E ;

Rutherford, M ;

Haataja, L ;

Frisone, MF ;

Henderson, S ;

Cowan, F ;

Dubowitz, L .

NEUROPEDIATRICS, 2002, 33 (05) :242-248

[3] Temperature patterns in the early postresuscitation period after pediatric inhospital cardiac arrest [J].

Bembea, Melania M. ;

Nadkarni, Vinay M. ;

Diener-West, Marie ;

Venugopal, Vidya ;

Carey, Scott M. ;

Berg, Robert A. ;

Hunt, Elizabeth A. .

PEDIATRIC CRITICAL CARE MEDICINE, 2010, 11 (06) :723-730

[4] Brain-specific proteins in the cerebrospinal fluid of severely asphyxiated newborn infants [J].

Blennow, M ;

Sävman, K ;

Ilves, P ;

Thoresen, M ;

Rosengren, L .

ACTA PAEDIATRICA, 2001, 90 (10) :1171-1175

[5] Origin and timing of brain lesions in term infants with neonatal encephalopathy [J].

Cowan, F ;

Rutherford, M ;

Groenendaal, F ;

Eken, P ;

Mercuri, E ;

Bydder, GM ;

Meiners, LC ;

Dubowitz, LMS ;

de Vries, LS .

LANCET, 2003, 361 (9359) :736-742

[6] Fetal pulse oximetry for fetal assessment in labour [J].

East, C. E. ;

Chan, F. Y. ;

Colditz, P. B. ;

Begg, L. M. .

COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2007, (02)

[7] Neurological outcomes at 18 months of age after moderate hypothermia for perinatal hypoxic ischaemic encephalopathy: synthesis and meta-analysis of trial data [J].

Edwards, A. David ;

Brocklehurst, Peter ;

Gunn, Alistair J. ;

Halliday, Henry ;

Juszczak, Edmund ;

Levene, Malcolm ;

Strohm, Brenda ;

Thoresen, Marianne ;

Whitelaw, Andrew ;

Azzopardi, Denis .

BMJ-BRITISH MEDICAL JOURNAL, 2010, 340 :409

[8] Severe traumatic brain injury in children elevates glial fibrillary acidic protein in cerebrospinal fluid and serum [J].

Fraser, Douglas D. ;

Close, Taylor E. ;

Rose, Keeley L. ;

Ward, Roxanne ;

Mehl, Martin ;

Farrell, Catherine ;

Lacroix, Jacques ;

Creery, David ;

Kesselman, Murray ;

Stanimirovic, Danica ;

Hutchison, James S. .

PEDIATRIC CRITICAL CARE MEDICINE, 2011, 12 (03) :319-324

[9] Treatment of hypoxic-ischemic encephalopathy in newborns [J].

Glass H.C. ;

Ferriero D.M. .

Current Treatment Options in Neurology, 2007, 9 (6) :414-423

[10] Selective head cooling with mild systemic hypothermia after neonatal encephalopathy: multicentre randomised trial [J].

Gluckman, PD ;

Wyatt, JS ;

Azzopardi, D ;

Ballard, R ;

Edwards, AD ;

Ferriero, DM ;

Polin, RA ;

Robertson, CM ;

Thoresen, M ;

Whitelaw, A ;

Gunn, AJ .

LANCET, 2005, 365 (9460) :663-670

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