应用PIVKA-Ⅱ监测新生儿早期维生素K缺乏及对策研究

Early Monitoring and Intervention of Vitamin K Deficiency with PIVKA-II in Neonate

目的:了解早期新生儿维生素K缺乏的状况及防治对策。方法:对住院的早期新生儿(日龄≤5天),用酶联免疫法检测血浆PIVKA-Ⅱ含量,PIVKA-Ⅱ阳性提示维生素K缺乏。对存在维生素K缺乏及合并出血的患儿给予不同剂量的维生素K_1,并监测给药后血浆PIVKA-Ⅱ水平的变化。结果:在214例住院早期新生儿中,PIVKA-Ⅱ阳性患儿共96例,占44.86％。PIVKA-Ⅱ阳性组新生儿出血症发生率高于阴性组,两组差异有显著性。对阳性组新生儿给予两种剂量维生素K_1并于给药后60～84小时复查血浆PIVKA-Ⅱ水平,其有效率分别为70.0％和80.0％,两组比较无显著性差异。结论:新生儿血浆PIVKA-Ⅱ的检测可反应维生素K缺乏状况,给予维生素K_1可有效地预防新生儿出血症,推荐剂量为1 mg。

Objective:To understand the status of Vitamin K deficiency and relative treatment methods in neonate. Methods:Detections of plasma PIVKA-Ⅱ content in hospitalized neonate (age less than 5 days) with ELISA were performed. Positive result of PIVKA-Ⅱ indicated Vitamin K deficiency. Deferent dose of Vitamin K1 were given to children with Vitamin K deficiency and complicated bleeding,and the change of PIVKA-Ⅱ was monitored. Results:PIVKA-Ⅱ positive result was got in 96 (44.86%) neonates. The incidence of complicated bleeding in PIVKA-Ⅱ positive group was significantly higher than that in negative group. The effective rates of the treatment with two different doses of Vitamin K were 70% and 8% respectively, and there was no significant deference between two groups. Conclusion:Detection of PIVKA-Ⅱ in neonate can reflect the status of Vitamin K deficiency. Vitamin K injection can effectively prevent neonatal bleeding with the recommended dose of 1 mg Vitamin K.