窒息新生儿α颗粒膜蛋白、血小板和纤溶活性的研究

Study on GMP-140,Platelet and Fibrinolysis in Newborns with Asphyxia

目的 研究窒息新生儿血小板活化状态及纤溶活性的变化 ,并探讨其临床意义。 方法 对 36例窒息新生儿及 8例正常新生儿于生后第 1天和第 4天测定血浆α-颗粒膜蛋白 (GMP- 140 )、D-二聚体及全血血小板计数。GMP- 140采用 EL ISA双抗体夹心法 ,D-二聚体采用乳胶凝集法。结果 (1)窒息组第 1天血浆 GMP- 140和 D-二聚体显著高于对照组 ,分别为 (5 2± 14) μg/ L 和 42± 9) μg/ L,(P<0 .0 5 ) ,(6 5 82± 1434 ) g/ L 和 (2 311± 85 4) g/ L(P<0 .0 1)。血小板计数明显降低 (15 2± 6 6 )×10 9/ L 和 (2 0 3± 49)× 10 9/ L(P<0 .0 5 )。第 4天两组间各值差异无显著性。(2 )血浆 GMP- 140和 D-二聚体水平的升高与窒息程度和缺氧缺血性脑病 (HIE)的严重度一致。(3)血浆 GMP- 140与 D-二聚体、BUN呈正相关 ,而与血小板数呈负相关。 结论 新生儿窒息可引起血小板活化及纤溶亢进 ,血浆GMP- 140可以作为血小板活化和破坏的指标之一 ,并可作为预测新生儿 HIE病情严重度的一项指标。

Objective To detect the changes of plasma granular membran protein(GMP 140),platelet counts and D Dimer in newborns with asphyxia. Methods The plasma level of GMP 140 and D Dimer was determined in 36 newborns with asphyxia and 8 normal newborns on the first and fourth day of life respectively by ELISA or Latex aggregation assay. The platelet counts was checked at the same time. Results The plasma levels of GMP 140 and D Dimer in newborns with asphyxia were statistically higher than that in contral group on tnefirst day(52 μg/L vs 42 μg/L, P <0.05;6 582 μg/L vs 2 311 μg/L, P <0.01), accompanied with lower amount of platelet(152×10 9/L vs 203×10 9/L, P <0.05). They returned to the levels of contral group on the fourth day. The plasma GMP 140 and D Dimer levels correlated with the severity of asphyxia and HIE. The plasma GMP 140 level correlated negatively with platelet counts. Conclusion The asphyxia of newborn may result in platelet activiation and hyperfunction of fibrinolysis.The plasma level of GMP 140 can be used as an index of platelet activity and destroy ,and of early diagnosis and prognosis of HIE.