CD144^+内皮微粒标志物与母婴血型不合新生儿溶血病患儿血管内皮损伤及功能障碍的相关性研究  被引量:12

Study on the correlation between CD144^+ endothelial microparticles and vascular endothelial injury,dysfunction of neonates with neonatal hemolysis disease of blood type incompatibility of mother and infant

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作  者:鲁广建[1] 王侠[2] 张晨光[2] 张群妹[3] 

机构地区:[1]新乡医学院第一附属医院检验科,河南卫辉453100 [2]新乡医学院医学检验学院 [3]新乡医学院第一附属医院输血科

出  处:《中国妇幼保健》2015年第16期2528-2531,共4页Maternal and Child Health Care of China

基  金:河南省教育厅基金〔2009GGJS-083〕

摘  要:目的:研究CD144+内皮微粒标志物与母婴血型不合新生儿溶血病患儿血管内皮损伤及功能障碍的相关性。方法:选取45例ABO新生儿溶血病患儿(ABO新生儿溶血病组)、20例Rh血型不合溶血病患儿(Rh血型不合溶血病组)和20例健康新生儿(对照组),收集所有患儿的外周血样本进行血液分析,检查红细胞(RBC)形态、网织红细胞计数和溶血标志物(乳酸脱氢酶LDH和间接胆红素),进行高灵敏度C-反应蛋白(CRP)检测、直接抗球蛋白试验(新生儿)和间接抗球蛋白试验(母亲),定量检测血管性血友病因子抗原(v WF:Ag),并进行抗CD144检测分析和内皮微粒分析,对检查结果进行统计学分析。结果:3组新生儿出生体重及胎龄比较差异无统计学意义(P>0.05)。两溶血组患儿血红蛋白、LDH和间接胆红素水平与对照组比较差异有统计学意义(P<0.05),两溶血组组间比较差异无统计学意义(P>0.05),Rh血型不合溶血病组患儿直接抗球蛋白试验阳性率为100%,且网织红细胞计数较ABO新生儿溶血病组患儿高。两溶血组患儿v WF:Ag和治疗前内皮细胞来源的细胞微粒(EMP)水平均较正常组高,且ABO新生儿溶血病组最高(P<0.05);进行换血治疗和/或光线治疗后EMP水平较治疗前显著减低(P<0.05),且患有严重高胆红素血症的ABO新生儿溶血病组患儿经过换血治疗后EMP水平较换血治疗前EMP水平降低得更显著(P<0.05)。两溶血组患儿治疗前EMP水平与LDH、间接胆红素和v WF:Ag水平呈正相关,而治疗前EMP与血红蛋白水平呈负相关(P<0.05)。治疗前EMP和血红蛋白水平仅在ABO新生儿溶血病组呈正相关(P<0.05)。多重回归分析发现:血红蛋白、LDH和间接胆红素水平与ABO新生儿溶血病组患儿治疗前EMP水平独立相关(r2=0.834,P<0.05),Rh血型不合溶血病组患儿仅血红蛋白和LDH水平与治疗前EMP水平呈现独立相关性(r2=0.877,P<0.05)。结论:EMP在ABO新生儿溶血病患儿中的水平升高Objective: To research the correlation between CD144+ endothelial microparticles and vascular endothelial injury, dys- function of neonates with neonatal hemolysis disease of blood type incompatibility of mother and infant. Methods: Forty-five neonates with neonatal hemolysis disease of ABO blood type incompatibility of mother and infant were selected as ABO neonatal hemolysis disease group, twenty neonates with neonatal hemolysis disease of Rh blood type incompatibility of mother and infant were selected as Rh neonatalhemolysis disease group, twenty healthy neonates were selected as control group. Peripheral blood specimens of all the neonates were collect- ed for blood analysis, morphology of red blood cells was examined, reticulocyte count and lactic dehydrogenase ( LDFI), indirect bilirubin, high-sensitive C-reaction protein (CRP) were measured, direct antiglobulin test (neonates) and indirect antiglobulin test (mothers) were conducted, yon WiUebrand factor antigen (VWF: Ag) was detected quantitatively, anti-CD144 test and endothelial microparticles analysis were carried out, the results were analyzed statistically. Results: There was no statistically significant difference in birth weight and fetal age among the three groups (P〉0. 05) . There was statistically significant difference in hemoglobin, LDH, and indirect bilirubin between ABO neonatal hemolysis disease group, Rh neonatal hemolysis disease group and control group (P〈0. 05 ), but there was no statistically signifi- cant difference between ABO neonatal hemolysis disease group and Rh neonatal hemolysis disease group (P〉0. 05) ; the positive rate of di- rect antiglobulin test in Rh neonatal hemolysis disease group was 100%, reticulocyte count in Rh neonatal hemolysis disease group was higher than that in ABO neonatal hemolysis disease group, vWF: Ag and endothelial microparticles before treatment in ABO neonatal hemolysis dis- ease group and Rh neonatal hemolysis disease group were higher than those in

关 键 词:CD144^+ 内皮微粒标志物 母婴血型不合 血管内皮损伤 功能障碍 

分 类 号:R722.19[医药卫生—儿科]

 

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