重度窒息新生儿血液流变、血小板活化及止血状态研究

A Study on Hemorheoiogy,Platelet-Activating and Hemostasis in Severe Asphyxiated Newborns

目的探讨重度窒息新生儿血液流变、血小板活化及止血状态。方法对60例重度窒息足月儿及20例健康足月儿(正常组)分别测定红细胞滤过指数(IF)、血小板α-颗粒膜蛋白140(GMP-140)、D-二聚体(DD)、血管性假血友病因子(vWF)。在此基础上应用PAF拮抗剂EGb761进行早期干预,分为治疗组(30例)及对照组(30例)。结果生后第1天重度窒息儿IF、血浆GMP-140、vWF、DD均明显高于正常组(P<0.05～0.001)。生后第4天治疗组IF、GMP-140、DD均低于对照组(P<0.05～0.001),两组vWF水平的变化差那里无显著意义(P>0.05)。结论 (1)新生儿重度窒息时,血液流变、血小板活化状态及止血状态发生改变,严重时使微循环血流障碍,器官功能受损。(2)PAF参与了这一病理生理过程,应用PAF拮抗剂可改善重度窒息儿的循环。

Objective To study the hemorheology,platelet-activating and hemostasis of severe asphyxiated newborns. Methods Erythrocyte filtration index(IF) ,granule membrane glycoprotein (GMP-140),D-dimer(DD) and yon Willebrand factor(vWF) were measured in 60 severe asphyxiated term newborns and 20 healthy term newborns. The effect of platelet-activating-factor (PAF) antagonist-EGb761 were also obserred. 60 term newborns with severe asphyxia were divided into two groups :treatment group(n= 30) and control group(n = 30). Results During the first day of life the IF,GMP-140,vWF and DD of the severe asphyxiated newborns increased significantly compared with those of healthy newborns(P<0.05～0.001 ). The IF,GMP-140 and DD of treatment group were all lower than those of control group(P<0.05～0.001) by 4 day of age. There was no significant difference in vWF level between two groups(P>0.05). Conclusion 1. Severe asphyx iated newborns vary in hemorheology,platelet-activating and hemostasis,which leads to disturbance of microcirculation and organ injury. 2. PAF plays a role in the pathophysiologic process, and PAF antagonist can improve the microcirculation of severe asphyxiated newborns.