新生儿缺氧缺血性脑病促红细胞生成素及血小板生成素变化规律和临床意义

CHANGING PATIERN AND CLINICAL SIGNIFICANCE OF PLASMA ERYTHROPOIETIN AND THROMBOPOINTIN IN NEONATES WITH HYPOXIC-ISCHGMIC ENCEPH ALOPATHY

为探讨正常新生儿和HIE新生儿血浆促红细胞生成素(EPO)及血小板生成素(TPO)的变化规律和临床意义,以29例健康足月儿为对照组,62例HIE患儿为HIE组,轻度HIE30例,中重度HIE组(轻度HIE30例,中重度HIE组32例),分别检测三组新生儿出生后第1、2、7天血浆EPO和TPO水平、血网织红细胞(Ret)计数和动脉血氧分压(PaO2)值。结果显示:与对照组相比,HIE组在生后第1天EPO、TPO、Ret三值较高,其中以中重度组最高,第2天三组三指标开始迅速下降,轻度HIE组下降较慢,中重组最慢。至第7天,HIE组和对照组三指标无显著性差异。生后第1天EPO、Ret与PaO2值呈负相关,EPO和TPO呈正相关,可以认为,EPO和Ret可作为判断新生儿出生前后体内缺氧的指标之一。新生儿HIE时,TPO与EPO在促进红细胞生成方面有协同作用。

To study the changing pattem and clinical significance of plasma ervthopoietin (EPO) and thrombo-poietin (TPO) in neonates with hypoxic-ischemic enceph alopathy(HIE) and healthy newbowns. The Ievels of plasma EPO,, TPO and reticulocyte (Ret) number and PaO2 of 62 cases with HIE and 29 term healthy newbowns were detected. Results showed that values of EPO, TPO and Ret in neonates with HIE increased significantly in first and second days after birth (P<0.05 or <0.01), especially in neonates with moderate and severe HIE ( P < 0.05 or < 0.01) . After birth, the three targets of the control group and the HIE group appeared to decrease gradually. Good correlations between EPO and TPO, Ret and PaO2(P <0.05 or <0.01) were existed. Wu conclude that plasma EPO Ievel and blood Ret number is can act as an indicator of perinatal hypoxia. EPO and TPO play a synergetic role in erythropoiesis post neonatal HTE.