新生儿缺氧缺血性脑病血浆GMP-140和D二聚体的变化及临床意义  

Changes and Clinical Significance of Plasma Levels of GMP-140 and D-Dimer in Newborn Infants with Hypoxic-ischemic Encephalopathy

作　　者：周小建[1] 钱镜秋[1] 姜荣[1] 张金莲[1] 徐杰[1] 

机构地区：[1]南通医学院附属医院儿科,226001

出　　处：《中华围产医学杂志》2000年第3期162-165,共4页Chinese Journal of Perinatal Medicine

摘　　要：目的　研究新生儿缺氧缺血性脑病 (HIE)时血浆颗粒膜蛋白 - 140 (GMP- 140 )、D二聚体的变化 ,并探讨其临床意义。　方法　 43例 HIE患儿按病情轻重分为轻、中、重三组。采用 EL ISA双抗体夹心法测定其血浆 GMP- 140、D二聚体的含量 ,并以 19例正常新生儿作为对照。　结果　三组HIE患儿 GMP- 140值分别为 (2 9.0 3± 9.48)、(37.39± 12 .94)、(6 2 .11± 15 .0 3) μg/ L,较对照组的(14.73± 6 .5 8)μg/ L显著升高 (P<0 .0 1)。血浆 D二聚体水平分别为 (2 .0 3± 0 .81)、(4.6 3± 1.48)、(8.16± 4.0 2 ) m g/ L ,较对照组的 (0 .6 5± 0 .31) mg/ L显著升高 (P<0 .0 1)。血浆 GMP- 140、D二聚体水平随着病情的加重而升高。血浆 GMP- 140水平与血小板数量呈负相关 (n=43,r=- 0 .44 ,P<0 .0 5 )。结果还表明轻度 HIE患儿血小板数量尚未明显下降时 GMP- 140、D二聚体就已较对照组升高(P<0 .0 5 ) ,危重儿在恢复期虽然血小板数量明显上升 ,但 GMP- 140、D二聚体水平仍高于对照组 (P<0 .0 5 )。　结论　 HIE患儿体内存在血小板活化、高凝状态及纤溶的改变 ,表明患儿处于血栓前状态。监测血浆 GMP- 140、D二聚体的变化 ,有助于血栓前状态的早期诊断、指导治疗及判断预后。Objective To observe the plasma levels of Granule membrane protein 140 (GMP 140) and D Dimer and to evaluate their clinical significance in newborn infants with hypoxic ischemic encephalopathy(HIE). Methods Forty three HIE patients were divided into mild, moderate and severe, the control group consisted of 19 healthy newborn infants.The levels of GMP 140 and D dimer were detected by the method of double antibodies ELISA. Results The plasma levels of GMP 140 were 29.03±9.48,37.39±12.94,62.11±15.03 ,14.73±6.58 (ng/ml),and D Dimer levels were 2.03±0.81,4.63±1.48,8.16±4.02,0.65±0.31 (mg/l) in four groups respectively. The plasma levels of GMP 140 and D dimer in HIE phase of acute were significantly higher than that those in control group ( P<0.01 ). GMP 140 amd D Dimer had strong relationship hith the degree of HIE.After treatment, the levels of GMP 140 and D dimer were significantly decreased ( P<0.01 ), but in the severe group,they were still higher than that of control( P<0.05 ). The plasma levels of GMP 140 had a negative correlation with platelet count ( n=43,r=-0.44, P<0.05 ).The increase of GMP 140 and D Dimer happened earlier than the decrease of platelet fcount in mild group. Conclusion There are elevated platelet activation and hypercoagulable state in HIE GMP 140 and D dimer are sensitive markers of prethrombotic state and secondary fibrinolysis in newborn infants with HIE, and they can be considered as prognosis predictors.

关 键 词：新生儿 缺氧缺血性脑病 GMP-140 D二聚体 血浆 

分 类 号：R722.1[医药卫生—儿科]