Diagnosis Value of Cerebrospinal Fluid Concentration of Cystatin C for Neonatal Brain Injury

Objective To investigate the value of cerebrospinal fluid(CSF) concentration of cystatin C(Cys-C) in the diagnosis of neonatal brain injury caused by asphyxia.Methods Thirty-six neonates treated in our hospital between December 2010 and December 2011 were divided into the severe asphyxia group(1 min Apgar score 0～3,n = 12),mild asphyxia group(4～7,n = 13),and the control group(n = 11).CSF and blood was drawn 36～72 h after birth and Cys-C level was measured by latex enhanced immune turbidimetric method.The subjects were followed up at half a year old and one year old to measure their mental development index(MDI) and psychomotor development index(PDI) using the Bailey scales of infant development(BSID).Results The severe and mild asphyxia groups had lower CSF Cys-C levels but higher serum Cys-C levels than the control group(P 0.05).The severe asphyxia group had lower CSF Cys-C level but higher serum Cys-C level than the mild asphyxia group(P 0.05).Nine out of 12 children in the severe asphyxia group survived,but their neonatal behavioral neurological assessment(NBNA) score at d 12～14 was lower than that of the control group and the mild asphyxia group(P 0.05);The NBNA score of the mild asphyxia group was lower than that of the control group(P 0.05).After 6 to 12 months,MDI and PDI of the severe asphyxia group were significantly lower than that of the mild asphyxia group and the control group(P 0.05);MDI and PDI of the mild asphyxia group were significantly lower than that of the control group(P 0.05).No case of cerebral palsy or mental retardation was observed.Correlation analysis showed that CSF Cys-C level was positively correlated with MDI and PDI(r = 0.623,0.786,P 0.05).Conclusion CSF Cys-C level is closely related with newborn brain injury caused by asphyxia,therefore can be used as an indicator for early assessment of brain injury after neonatal asphyxia and prognosis.