早产儿血清表皮生长因子水平与脑发育相关研究  

Correlation of brain development with serum epidermal growth factor level in preterm infants

作　　者：李菁[1] 朱建幸[2] 孙建华[1] 黄萍[1] 胡洁[1] 

机构地区：[1]上海交通大学医学院附属上海儿童医学中心内科新生儿重症监护病房,200127 [2]上海交通大学医学院附属新华医院儿内科

出　　处：《中国新生儿科杂志》2007年第2期68-71,共4页Chinese Journal of Neonatology

摘　　要：目的探讨早产儿血清表皮生长因子水平与脑发育的关系。方法依据入选标准观察对象为自2005年8月起连续收治入本院新生儿病房、出生24h内的胎龄为34周±3d的“正常”早产适于胎龄儿30例。采用酶联免疫吸附测定(ELISA)法,分别测定30例早产儿生后24h内和出生第8天空腹股静脉血清表皮生长因子(EGF)水平,分别为t0和t1值,计算血清EGF浓度变化的速率(Δt)。同时,在新生儿出生后6周(纠正胎龄接近40周)和纠正1月龄时进行NBNA评分测定。并将以上实验室数据与新生儿行为神经测定(NBNA)评分值及差值、早产儿出生后的头围增长值及增长速率进行Pearson相关分析。如果P值<0.05,则认为差有统计学意义。结果30例早产儿观察对象t0为(234.71±58.07)pg/ml,t1为(347.81±87.49)pg/ml,Δt为(16.16±9.94)(12.14、15.20)pg/ml/d;Pearson相关分析显示2次NBNA评分结果及差值、出生后6周和纠正1月龄时的头围增长值/增长速率与t0值无相关性(P>0.05);2次NBNA评分结果及差值、出生后6周和纠正1月龄时的头围增长值/增长速率与t1和Δt之间有相关性(P<0.05)。结论研究结果表明,早产儿出生后血清EGF浓度呈上升趋势,提示早产儿出生后体内EGF合成和释放增加,可能促进脏器成熟和组织修复;更重要的是,早产儿出生1周时高水平血清EGF浓度和/或较快上升速率者,其出生后头围增长速度也快,可能有较好的脑发育水平、远期预后良好。Objective To study the relationship of brain development with serum epidermal growth factor （EGF） level in preterm infants. Methods Thirty preterm infants admitted to our neonatal nursery within first 24 hours of life were studied. Their gestational age was （ 34 ±0. 4 ） weeks. EGF levels at first 24 hours （t0） and 8 day （t1） after birth were measured with enzyme-linked immunosorbent assay （ELISA） method. The velocity of changes of EGF levels was calculated （Δt）. All infants were followed up at 6 weeks old （40 weeks gestational age） and corrected age of 1 month. Their serum EGF levels, NBNA scores and head circumferences were detected; the changes of measurements and rate of growth were analyzed via Pearson correlation analysis. Results Serum EGF levels were t0 （234.71 ± 58.07 ） pg/ml, t1 （347.81 ±87.49） pg/ml, and Δt （916. 16 ±9.94） （ 12. 14,15.20） pg/mL/d. Pearson correlation analysis showed that NBNA score, increases of head circumference at 6 weeks after birth and corrected 1 month of age were associated with t1 and Δt （ P 〈 0. 05 ）, but not with to （ P 〉 0. 05 ）. Conclusions Increased synthesis and releasing of EGF in vivo may help organs＇ maturity and tissue repairement. Higher serum EGF level or quicker upstroke of velocity of EGF in the first week after birth is associated with faster head growth and development, lower incidence of psychoneural sequelae and optimistic long term outcome in preterm infants.

关 键 词：血清 表皮生长因子 发育障碍 

分 类 号：R722.6[医药卫生—儿科]