新生儿缺氧缺血性脑病红细胞平均体积及形态改变的临床研究

Clininal study on mean corpuscular volume and red cell appearance change of hypoxic-ischemic encephalopathy in newborn

目的:观察新生儿缺氧缺血性脑病(H IE)患儿红细胞平均体积(MCV)及红细胞形态的变化,探讨其临床意义。方法:采用美国Cou lter-JT自动血细胞分析仪和日本OLYMPUS显微镜,检测78例(轻中度组47例,危重度组31例)新生儿H IE急性期及其中62例处于恢复期患儿的MCV大小,并观察其红细胞形态的变化,并与50例正常新生儿作为对照。结果:新生儿H IE急性期MCV及球形红细胞比例增大,而双凹圆盘形红细胞比例减少,与恢复期及正常对照组比较,差异均有非常显著性(P<0.01),而恢复期MCV及球形红细胞比例减少,而双凹圆盘形红细胞比例增加,与正常对照组比较,差异均无显著性(P>0.05);危重度组MCV及球形红细胞比例增大,而双凹圆盘形红细胞比例减少,与轻中度组比较,差异均有非常显著性(P<0.01)。结论:新生儿H IE患儿MCV及红细胞形态的变化与病情密切相关,监测它们的变化,能进一步评估红细胞的变形性,从而可在细胞水平上为临床判断病情、评估预后及指导治疗提供一个有价值的指标。

Objective： Observation of clinical study for mean corpuscular volume （MCV） and red cell appearance change of hypoxic- ischemic encephalopathy （HIE） in newborn and exploration of its clinical significance. Methods： Used American-made Coulter -JT automatic blood cell analysis instrument and Japan - made OLYMPUS telescope to test 78 cases （47 cases of light - medium degree group and 31 cases of serious degree group） acute period of newborn HIE and 62 cases of them in recovery, period baby patients had size of MCV and observation of its appearance change so as to be compared with 50 cases of normal newborn as a group of comparison. Results： The MCV and spherocyte proportion in the group for acute period of newborn HIE increase, but double cave round shape disk red cell proportion reduce, the difference was significant （ P 〈0. O1 ）. Compared with the recovery period group and normal group, and the MCV and spherocyte proportion in the group for recovery period reduce, but double cave round shape disk red cell proportion increase, the difference was not significant （P 〉0. 05 ） compared with normal comparison group; the MCV and spherocyte proportion in the serious degree group increase, but double cave round shape disk red cell proportion reduce, the difference was significant （P 〈0. 01 ） compared with the light - medium degree group. Conclusion： MCV and red cell appearance change of HIE in newborn relates to disease situation closely so as to check their change and be able to appreciate red cell deformability and diagnose disease situation clinically based on cell level and appreciate prognosis and instruct the treatment to provide one valuable index.