新生儿缺氧缺血性脑病血清铁和血清铁蛋白的动态变化及意义

Clinical significance of serum iron and serum ferritin in newborns with hypoxic-ischemic encephalopathy

目的探讨铁代谢紊乱在新生儿缺氧缺血性脑病(HIE)再灌注损伤中的作用。方法 分别测定60例HIE足月新生儿(其中轻度30例,中度20例,重度10例)入院时(日龄48h内)、日龄3～5天时血清铁(SI)及血清铁蛋白(SF)含量,并与20名健康新生儿(对照组)进行比较。结果 轻、中、重度HIE组入院时SI分别为(9.8±3.6)μmol/L、(9.7±4.3)μmol/L和(7.8±2.7)μmol/L,均低于对照组(14.5±5.0)μmol/L(P均<0.05);入院时轻、中、重度HIE组SF分别为(145.2±59.9)μg/L、(141.7±30.8)μg/L和(110.6±29.0)μg/L,均低于对照组(216.0±90.0)μg/L(P均<0.05);轻、中、重度HIE组日龄3～5天时SI分别为(18.7±4.2)μmol/L、(19.2±5.5)μmol/L和(26.1±5.6)μmol/L,均高于对照组(14.8±4.8)μmol/L(P均<0.05);SF分别为(314.3±93.0)μg/L、(397.1±95.3)μg/L和(546.6±98.9)μg/L,均高于对照组(218.6±75.4)μg/L(P均<0.05)。结论 HIE患儿出生48h内循环铁降低,日龄3～5天时升高,提示铁代谢紊乱可能在HIE再灌注损伤中起一定作用。

Objective To study the effect of iron metabolic disorder in neonatal hypoxic-ischemic encephalopathy（HIE）.Methods To measure the serum iron and serum ferritin levels in 60 neonates of HIE within 48 h after birth and day 3-5 after birth,which including 30 neonates in mild HIE,20 in moderate HIE and 10 in severe HIE.And 20 healthy neonates＇ serum iron and serum ferritin level had been measured within 48 h after birth and day 3-5 after birth as control group.Results The level of serum iron in mild,moderate,severe HIE within 48 h after birth were（9.8±3.6） μmol/L,（9.7±4.3） μmol/L,（7.8±2.7） μmol/L respectively,decreased statistically than that of the control group（14.5±5.0） μmol/L（P0.05）.The level of serum ferritin in mild,moderate,severe HIE within 48 h after birth were（145.2±59.9） ng/ml,（141.7±30.8） ng/ml and（110.6±29.0） ng/ml respectively,decreased statistically than that of the control group（216.0±90.0） ng/ml（P0.05）.While the level of serum iron in mild,moderate,severe HIE day 3-5 after birth were（18.7±4.2） μmol/L,（19.2±5.5） μmol/L,（26.1±5.6） μmol/L respectively,increased statistically than that of the control group（14.8±4.8） μmol/L（P0.05）.Or the level of serum ferritin in mild,moderate,severe HIE day 3-5 after birth were（314.3±93.1） ng/ml,（397.1±95.3） ng/ml,（546.6±98.9） ng/ml respectively,increased statistically than that of the control group（218.6±75.4） ng/ml（P0.05）.Conclusion Serum iron and serum ferritin level in neonates of HIE decreased within 48 h after birth while increased day 3-5 after birth;The disorder of iron metabolism may play an important role in reperfusion injury in HIE.