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 ferrifin 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3.5d时血清(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、重度窒息组院时S1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)umol/L(P【0.05);SF(144.7±58.9)ug/L、(121.0±31.9,)ug/L,均低于对照组(212.1±89.7)ug/L(P【0.05),重、轻度窒息组差别比较P】0.05。3-5d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P【0.01。结论窒息患儿的循环铁在出生后48h内降低,日龄3~5d时升高。提示在脑循环再灌注时在铁代谢紊乱。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 October2011 to January 2013,on their admission(48h 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 oil their admission Was(9.7±4.1) umol/L and(7.6±2.8) umol/L respectively.both lower than the control group,13.8±4.0) umol/L(Pm<0.05);the SF were(144.7±58.9) ug/L and(121.0±31.9)ug/L respectively,both lower than the control group,(212.1±89.7) ug/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)umol/L and(24.3±5.2) umol/L respectively,beth higher than the control group(15.2±4.9) umol/L(Pm<0.05);the SF Was(360.1±94.2)ug/L and(538.6±97.8)ug/L respectively.both higher than the control group(219.5±76.1)ug/L(Pm<0.05).The difference P between the severe and mild asphyxia group Was less than 0.01.Conclusion 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 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.