血清表皮生长因子水平与早产儿脑发育的关系  

Relationship between brain growths with werum epidermal growth factor level in preterm infants

作　　者：李菁[1] 朱建幸[2] 孙建华[1] 黄萍[1] 陈冠仪[2] 

机构地区：[1]上海交通大学医学院附属新华医院上海儿童医学中心NICU,上海200127 [2]上海交通大学医学院附属新华医院儿内科,上海200092

出　　处：《中国实用儿科杂志》2008年第1期12-14,共3页Chinese Journal of Practical Pediatrics

摘　　要：目的探讨血清表皮生长因子水平与早产儿脑发育的关系。方法对2005年8月至2006年4月连续收入上海儿童医学中心新生儿病房、出生24h内、胎龄(238±3)d的30例早产适于胎龄儿,采用酶联免疫吸附测定法(ELISA)分别测定其生后24h内(t0值)和第8天(t1值)的空腹血清EGF水平,计算其血清EGF变化速率(△t);进行床边头颅B超检查以排除颅内病变;并在校正胎龄近40周(生后6周)和1月龄时(生后10周)分别测量其头围并进行NBNA评估,计算其头围增长速率及NBNA差值。应用Pearson方法对所有测定结果分别进行相关分析。结果30例早产儿的血清EGFt0为(234.71±58.07)pg/mL,t1为(347.81±87.49)pg/mL,△t为(12.14±1.85)pg/(mL.d)。Pearson相关分析显示,2次NBNA评分结果及其差值、出生后6周和10周时的头围增长值和增长速率,均与t0值无明显相关性(P均>0.05);但上述测定结果均分别与t1和△t之间呈显著相关(P均<0.05)。结论早产儿出生后血清EGF质量浓度呈上升趋势,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。尤其早产儿在出生1周时的血清EGF呈高水平和(或)上升速率较快者,其生后头围的增长速度也较快,提示其今后可能有较好的脑成熟发育水平、较低的精神神经系统后遗症的发生率,以及远期预后良好。Objective To investigate the association of brain growth with serum epidermal growth factor level in preterm infants. Methods There are 30 cases of appropriate for gestational age preterm infants who continuous admitted in our newborn nursery within 24 hours after birth from August 2005 to April enrolled. Enzyme-linked immunosorbent assay （ ELISA） was used to determine the serum level of EGF within 24 hours （ t0 ） and on the 8th day （ t1 ） after birth. Calculate the difference from to with t1 and the portrait change velocity （ At）. NBNA have been operated by a trained neonatal specialty nursing staff, when the infant is 6 weeks after birth and corrected 1 month age. Perform the correlation analysis of these laboratory data and NBNA score, head circumference growth after birth. If P 〈 0. 05, it means statistics significance of difference. Results The laboratory result showed that to is （ 234. 71 ± 58. 07 ）pg/mL,h is （ 347. 81 ± 87. 49 ）pg/mL, and At is （ 12. 14 ± 1.85 ）pg/（ mL· d）. Pearson correlation analysis showed that NBNA scores, head circumference increase of 6 weeks after birth and corrected 1 month age were associated with t1 and At （ P 〈0. 05） ,but not to （ P 〉 0. 05 ）. Conclusion The presented data indicate the serum EGF concentration has been upgrading in preterm infants after birth, hint that increasing synthesis and release of EGF in vivo may promote organ maturity and tissue repair. It is more important that higher serum level or quicker upstroke velocity of EGF in the first week after birth would be associated with faster head growth and brain development,prognosticating lower incidence of psychoneural sequelae, and more optimistic long term outcome in preterm infants.

关 键 词：婴儿 早产 表皮生长因子 脑发育 

分 类 号：R72[医药卫生—儿科]