亚低温治疗窒息新生儿二胺氧化酶及肠脂肪酸结合蛋白的变化及意义  

The changes and significance of diamine oxidase and intestinal fatty acid binding protein in the treat-ment of hypothermia for neonates after birth asphyxia

作　　者：姚爱敏[1] 姚亮[1] 王叶青[1] 安转芹 邓亚玲 孙学江[4] 郝亚平[1] 

机构地区：[1]河北省保定市妇幼保健院新生儿科,071000 [2]涞源县妇幼保健院,074300 [3]高阳县医院新生儿科,071500 [4]河北大学附属医院心内科,保定071000

出　　处：《中国小儿急救医学》2016年第4期240-243,共4页Chinese Pediatric Emergency Medicine

摘　　要：目的观察选择性头部亚低温治疗窒息新生儿中二胺氧化酶（diamineoxidase，DAO）及肠脂肪酸结合蛋白（intestinalfattyacidbindingprotein，I-FABP）水平的变化。方法选取2013年6月至2014年12月在河北省保定市妇幼保健院NICU住院的重度窒息患儿60例，随机分为常规治疗组和亚低温治疗组，同时选取同期住院的除外缺血缺氧及胃肠功能障碍相关疾病的新生儿30例作为对照组。分别在入院时、治疗7d后采集静脉血，收集血清应用ELISA法检测DAO、I-FABP水平，同时对患儿进行胃肠功能障碍评分。结果入院时亚低温治疗组及常规治疗组患儿DAO、I-FABP水平比较差异无统计学意义[DAO：（15．77±2．04）U／ml，（15．81±1．85）U／ml，P〉0．05；I-FABP：（310．叭±46．43）ng／L，（301．12±38．61）ng／L，P〉0．05]，但较对照组均升高[（7．65±0．74）U／ml，（51．65±6．91）ng／L]；治疗7d后，两组患儿DAO、1-FABP水平较入院时均减低[DAO：（7．88±1．87）U／ml，（12．51±1．53）U／ml；I-FABP：（59．16±6．17）ng／L，（121．31±21．54）ng／L]，亚低温治疗组下降明显，差异有统计学意义（P〈0．05），且DAO及I-FABP水平与胃肠功能障碍评分呈正相关（r1=0．831，r2=0．827，P〈0．01）。结论选择性头部亚低温治疗可使DAO、I-FABP水平下降，提示其在一定程度上利于受损胃肠功能的恢复。Objective To study the changes of diamine oxidase （DAO） and intestinal fatty acid binding protein （I-FABP） levels in neonates with hypoxic-ischemic encephalopathy treated with selective brain hypothermia. Methods Collect a sample of 60 newborns with moderate and severe hypoxic-ischemic encephalopathy who were hospitalized in the NICU of Maternal and Child Health Care Hospital of Baoding from June 2013 to December 2014. The 60 newborns were divided into two groups randomly： hypothermia group （n = 30 ） and conventional treatment group （n = 30 ）. Selected 30 cases hospitalized at the same period, except the related to the ischemia hypoxia and gastrointestinal dysfunction disease as the control group. The levels of serum levels of DAO and I-FABP were measured by ELISA on admission and 7 days after treat- ment, respectively. And the score of gastrointestinal dysfunction were compared. Results Neither the levels of DAO and I-FABP in hypothermia group and conventional treatment group had statistical differences on ad- mission I DAO： （ 15.77± 2. 04） U/ml, （ 15.81 ±1.85 ） U/ml, P 〉 0. 05 ; I-FABP： （ 310. 01± 46. 43 ） ng/L, （301.12 ± 38. 61 ）ng/L, P 〉 0. 05] ,but were higher than that in the control group[ （7. 65 ±0. 74）U/ml, （51.65 ± 6. 91 ） ng/Ll. Seven days after treatment,both the levels of DAO and I-FABP of hypothermia group and conventional treatment group decreased [ DAO ： （ 7.88 ± 1.87 ） U/ml, （ 12. 51±1.53 ） U/ml ; I-FABP： （59. 16 ± 6. 17 ） ng/L, （ 121.31 ± 21.54 ） ng/L ], meanwhile, the variation of hypothermia group was more significant（ P 〈 0. 05 ）. The correlation of the plasma DAO and I-FABP levels and the score of gas-trointestinal dysfunction was significantly （ r1 = 0. 831, r2 = 0. 827, P 〈 0. 01 ）. Conclusion Hypothermia treatment could effectively reduce the levels of DAO and I-FABP, thus improve the gastrointestinal function in some extent.

关 键 词：亚低温治疗 二胺氧化酶 肠脂肪酸结合蛋白 新生儿 窒息 

分 类 号：R722.12[医药卫生—儿科]