脐血8-异前列腺素与新生儿窒息及缺氧缺血性脑病的关系

The relationship between cord blood 8-iso-PGF2a and neonatal asphyxia and hypoxic-ischemic encephalopathy

目的探讨脐血8-异前列腺素(8-iso-PGF2a)评估晚期早产儿及足月新生儿窒息程度及窒息后缺血缺氧性脑病(HIE)的可靠性。方法收集轻度窒息的晚期早产儿及足月新生儿30例,重度窒息晚期早产儿及足月新生儿20例,30例同期产科分娩的正常晚期早产儿及足月新生儿作为对照组,以及生后3d内诊断为新生儿缺氧缺血性脑病的重度窒息患儿12例。用酶联免疫吸附法(ELISA)测定各组新生儿脐静脉血8-iso-PGF2a水平。结果窒息组与无窒息组相比,8-iso-PGF2a水平明显升高。两组比较,有统计学意义(t=5.898,P<0.01)。与轻度窒息组相比,重度窒息组8-iso-PGF2a水平明显升高。两组比较有统计学差异(t=24.86,P<0.01)。窒息组中发生新生儿缺氧缺血性脑病(HIE)与未发生HIE者比较,脐血8-iso-PGF2a显著升高,两组比较差异有统计学意义(t=4.97,P<0.01)。结论脐血8-iso-PGF2a水平与晚期早产儿及足月新生儿窒息相关,晚期早产儿及足月新生儿窒息程度越严重,脐血8-iso-PGF2a水平越高,因此,脐血8-iso-PGF2a水平可用来评估晚期早产儿及足月新生儿窒息的短期预后。

Objective To explore whether 8-iso-PGF2a is a reliable biochemical indicator in the assessment of asphyxia degree in late preterm infants and term infants and in the assessment of hypoxic-ischemic encephalopathy.Methods 50 cases of asphyxia infants were chosen as a study group,including 30 cases of late preterm infants and term infants with mild asphyxia and 20 cases with serious asphyxia.Another 30 cases of no asphyctic late preterm infants and term infants delivered in the same period were taken as control group.In serious asphyxia group,there were 12 cases which were diagnosed as hypoxic-ischemic encephalopathy at 72 hours of life.The blood samples were extracted from cord veins immediately after born.The blood was centrifuged 3000r/min and 15 minutes and the serum was stored in a-80°C refrigerator.Detecting cord veins blood contents of 8-iso-PGF2a in each group.Results（1）Compared with no asphyxia group,the level of 8-iso-PGF2a in asphyxia group was significantly increased.There was significant difference between the two groups（P〈0.01）.（2）Moreover,serious asphyxia led to a significant increase in 8-iso-PGF2a levels.There was statistical difference between the serious asphyxia group and mild asphyxia group（P〈0.01）.（3）Compared newborns with hypoxic-ischemic encephalopathy（HIE） with those without HIE in asphyxia group,the level of 8-iso-PGF2a was markedly higher.There was significant difference between the two groups（P〈0.01）.Conclusions（1）There is relationship between the increased level of 8-iso-PGF2a and asphyxia in late preterm infants and term infants.（2）There is relationship between the increased level of 8-iso-PGF2a and the asphyxia degree in late preterm infants and term infants.（3）There is relationship between the increased level of 8-iso-PGF2a and newborns with hypoxic-ischemic encephalopathy（HIE）in late preterm infants and term infants.