高胆红素血症新生儿血小板活化率与心肌酶的关系

Relationships between Platelet Activation Markers and Myocardial Enzymes in Neonates with Hyperbilirubinemia

目的观察高胆红素血症(高胆)新生儿血小板活化率的改变,探讨其与心肌酶的关系及其临床意义。方法选取30例高胆新生儿为观察组,15例健康新生儿为健康对照组。2组新生儿均于早晨空腹股静脉采血1 mL,20 g/L乙二胺四乙酸二钠盐(EDTA-Na2)0.1 mL抗凝,轻轻摇匀,取2支试管,均加入CD41-异硫氰酸荧光素单克隆抗体(CD41-FITC)10μL,分别加入IgG1-PE及血小板活化标志物CD62P-PE试剂10μL,用200μL PBS液稀释后,各加入全血5μL,室温避光15 min,使用阴性对照管(CD41-FITC加IgG1-PE)调整电压后,应用流式细胞仪检测其CD62-PE。心肌酶检测应用自动生化分析仪。结果与健康对照组比较,观察组新生儿血小板活化率显著升高(P<0.01);多元线性回归分析显示,血小板活化率明显增高者(≥50%),总胆红素水平/清蛋白比值与血小板活化率水平呈正相关(r=0.943 P<0.05);血小板活化率轻中度增高者(<50%),总胆红素水平与血小板活化率呈正相关(r=0.526 P<0.01);血小板活化率与CK-MB呈正相关(r=0.688 P<0.01)。结论高胆新生儿血小板活化率水平较健康新生儿明显升高,血小板活化率可作为评价人体器官炎性损害的参考指标之一。为临床治疗高胆时应用抗自由基和改善微循环药物提供理论参考。

Objective To observe the changes of platelet activation markers in newborn infants with hyperbilirubinemia, and its relationship with myocardial enzymes and clinical significance. Methods Thirty neonates with hyperbilirubinemia were selected as observation group ,and 15 health newborns were served as normal control group. In the morning, 1mL fasting blood in the femoral vein was collected from the patients in both groups,and 20 g/L EDTA - Na2 0.1 mL anticoagulant was added with a gentle shake. CD41 - FITC 10μL was injected into two test tubes, with IgG1 - PE and CD42 - PE reagent 10μL added, diluted liquid 200μL PBS, and with 5μL whole blood, under dark room temperature for 15 minutes. Negative control tubes （CD41 -FITC plus IgG1 - PE ） were applied to adjust voltage, the flow cytometry was used to determine CD62 - PE. Myocardial enzymes and liver function were measured by automatic biochemistry analyzer. Results The levels of platelet activation markers in observation group were significantly higher than that in the normal control group（ P 〈 0. 01 ）. By multifarious factors linear regression analysis suggested that the rate of total bilirubin/albumin （B/A） had a positive correlation with the higher level platelet activation markers （ ≥50% ） （ r = 0. 943 P 〈 0.05 ）. While total bilirubin had a positive correlation with the middle level platelet activation markers（ 〈 50% ） （ r = 0. 526 P 〈0. 01 ） ; platelet activation markers only had a positive correlation with myocardial enzymes isozyme （ CK - MB ） （ r = 0. 688 P 〈 0.01 ）. Conclusions There had a significant difference of platelet activation markers between experimental group and the nomal contol group. It may serve as a reference index when inflammation damage to human body organs is being evaluated. In the clinical treatment of hyperbilirubinemia, it can be a referential drug in the process of anti - free radical and improving microcirculation.