正常和缺氧缺血性脑病新生儿血浆8-异前列腺素F_(2α)水平及其临床意义

Plasma 8-iso-PGF_(2α) levels in normal and HIE neonates

目的测定正常和缺氧缺血性脑病(HIE)新生儿血浆8-异前列腺素F2α(8-iso-PGF2α)水平,确定新生儿血浆8-iso-PGF2α正常参考值范围,分析HIE患儿8-iso-PGF2α水平变化及其对HIE病情评估的价值。方法正常新生儿72例,HIE患儿129例,分别于生后第1、3和7天采集外周静脉血,酶联免疫法检测血浆8-iso-PGF2α浓度。结果(1)新生儿生后1周血浆8-iso-PGF2α正常参考值范围为(13.39±6.25)ng/L(95%可信区间11.78～16.56ng/L)。(2)HIE患儿血浆8-iso-PGF2α水平于生后24h内达高峰,轻、中、重度HIE患儿血浆8-iso-PGF2α水平分别为(51.48±17.70)、(121.78±33.99)和(240.80±91.91)ng/L,差异有非常显著性(P<0.01)。(3)生后第1天HIE患儿血浆8-iso-PGF2α水平高于正常新生儿水平(P<0.01);生后第3天,轻度和中度HIE患儿血浆8-iso-PGF2α水平下降至正常新生儿水平(P>0.05),但重度HIE患儿于生后7d的血浆水平仍高于正常新生儿水平。(4)以正常新生儿生后第1天血浆8-iso-PGF2α的均值+2倍标准差作为区分正常与异常的界限,诊断HIE的特异性为93.9%,敏感性为97.2%。结论HIE患儿血浆8-iso-PGF2α峰值于病程第1天出现,升高程度与病情严重性相关;血浆8-iso-PGF2α水平测定是一项评估HIE患儿病情可靠的生化指标。

Objective To determinate plasma 8-iso-prostaglandin FE, （8-iso-PGF2α） levels in normal neonates and neonates with hypoxic-ischemic encephalopathy（HIE）, and to investigate its clinical value in assessing HIE condition. Methods Seventy-two normal neonates and 129 neonates with HIE were recruited. Peripheral blood samples from normal and HIE neonates were collected on the first, third, seventh day after birth. Plasma 8-iso-PGFeolevel were determined by EIA assay. Results （ 1 ） Plasma 8-iso-PGF2αlevel in normal neonates was （13.39 ± 6.25） ng/L the first week after birth[95% confidence interval was （11.78±16.56） ng/L） ]. （2） Peak concentration of plasma 8-iso-PGF2α in HIE neonates occurred 24 hours after birth, were respectively （ 51.48 ＋ 17.70）, （ 121.78 ＋ 33.99）, and （240.80 ＋ 91.91 ） ng/L in mild, moderate and serious HIE neonates （P 〈 0.01 ）. （3） The concentrations of mild and moderate HIE neonates decreased to the level of normal neonates at the 3rd day（ P 〉 0.05）, but serious HIE neonates at the 7th day still higher than normal neonates（ P〈 0.01 ）. （4） Using plasma 8-iso-PGF2αlevel of 28.75 ng/L as the boundary line between normal and HIE, the sensitivity and specificity of assessing the HIE severity were 97.2 % and 93.9 % , Conclusion Plasma 8-iso-PGFe2α levels markedly increase in HIE neonates, and there is a correlation between the plasma 8-iso-PGF2α contents and the HIE severity, suggesting that plasma 8-iso-PGF2α is a reliable index for the assessment of the severity of HIE.