新生儿窒息后脑损伤与血清铁和血清铁蛋白变化的关系

The relationship between serum iron and ferritin changes with the brain damages after asphyxia in neonates

目的探讨新生儿窒息复苏后血清铁、血清铁蛋白的动态变化与脑损伤的关系。方法双盲法监测2011年10月～2013年1月足月窒息新生儿61例(观察组)入院时(日龄≤48h)、日龄3～5 d时血清铁(SI)和血清铁蛋白(SF)的含量,并与同期健康新生儿30例(对照组)进行比较。结果轻、重度窒息组入院时SI分别为(9.7±4.1)μmol/L、(7.6±2.8)μmol/L,均低于对照组(13.8±4.0)μmol/L(P均<0.05);SF(144.7±58.9)μg/L、(121.0±31.9)μg/L,均低于对照组(212.1±89.7)μg/L(P均<0.05),重、轻度窒息组差别比较P>0.05。3～5 d时轻、重度窒息组SI分别为(19.1±5.1)μmol/L、(24.3±5.2)μmol/L,均高于对照组(15.2±4.9)μmol/L(P均<0.05);SF(360.1±94.2)μg/L、(538.6±97.8)μg/L,均高于对照组(219.5±76.1)μg/L(P均<0.05),重、轻度窒息组差别比较P<0.01。结论窒息患儿的循环铁在出生后48 h内降低,日龄3～5 d时升高。提示在脑循环再灌注时存在铁代谢紊乱,铁离子对脑有损伤作用。

Objective To establish the relationships between the level of serum iron （SI） and serum ferritin （SF） and the brain damage after neonatal asphyxia recovery. Methods To monitor the serum iron （SI） and serum ferritin （SF） levels of 61 full-term neonates with asphyxia （observation group）, admitted from October 2011 to January 2013, on their admission （48 h or less day age）, and 3 to 5 days old by using double-blind methods, with the results compared to those of 30 healthy newborns （control group）. Results The SI of the moderate and severe asphyxia group on their admission was （9.7±4.1）μmol/L and （7.6±2.8）μLmol/L respectively, both lower than the control group, 13.8±4.0） μmol/L （Pm〈0.05）; the SF were （144.7±58.9）μg/L and （121.0±31.9）μg/L respectively, both lower than the control group, （212.1±89.7）μg/L （Pm〈0.05）. The value P between the severe and mild asphyxia group is more than 0.05. Three to five days later, the SI was （19.1±5.1）μmol/L and （24.3±5.2） μmol/L respectively, both higher than the control group （15.2±4.9） p, mol/ L （Pm〈0.05）; the SF was （360.1±94.2） p,g/L and （538.6±97.8）μg/L respectively, both higher than the control group （219.5±76.1） μg/L （Pm〈0.05）. The difference P between the severe and mild asphyxia group was less than 0.01. Condusion Asphyxia children would experience a decrease of iron circulation within 48 h after birth and an increase of iron circulation at the age of 3 to 5 days, which suggests an iron metabolic disorder during the reperfusion of cerebral circulation and the damage caused to the brain by iron ion.