早产儿血清促红细胞生成素水平与脑损伤的关系  

Relationship between serum erythropoietin levels and brain injury in preterm infants

作　　者：陈光福[1] 李辉桃[2] 黄进洁[3] 王章星 李赟[1] 杨传忠[2] 吴本清[3] 刘文兰[1] 刘丽辉[1] 孔琦[1] 刘荣添[1] 

机构地区：[1]深圳市第二人民医院/深圳大学第一附属医院儿科中心实验室,广东深圳518035 [2]深圳市妇幼保健院新生儿科,广东深圳5180173 [3]深圳市人民医院新生儿科,广东深圳518001 [4]深圳市龙华新区人民医院新生儿科,广东深圳518109

出　　处：《中国当代儿科杂志》2016年第10期947-952,共6页Chinese Journal of Contemporary Pediatrics

基　　金：深圳市科技计划项目(JCYJ20140414170821145)

摘　　要：目的探讨早产儿血清促红细胞生成素（EPO）水平与脑损伤的关系。方法选取2014年10月至2015年9月出生胎龄在28~34周的早产儿304例作为研究对象。采用颅脑B超和MRI检查诊断脑损伤,ELISA检测血清EPO、S100蛋白、神经元特异性烯醇化酶（NSE）和髓鞘碱性蛋白（MBP）水平,比较不同血清EPO水平早产儿脑损伤的发生率,分析血清EPO水平与各指标的相关性;采用多因素Logistic回归分析研究血清EPO水平与脑损伤的关系。结果 304例早产儿中发生脑损伤125例（41.1%）;低水平EPO组缺血性脑损伤发生率明显高于中高水平EPO组（P〈0.01）;脑损伤早产儿血清S100蛋白、NSE、MBP水平均高于无脑损伤组（P〈0.01）;血清EPO水平与S100蛋白浓度、NSE水平均呈负相关（P〈0.05,P〈0.01）;Logistic回归分析显示低胎龄、低出生体重、窒息复苏、机械通气时间延长、贫血和低血清EPO水平均是脑损伤发病的独立危险因素。结论血清EPO低水平的早产儿脑损伤发生率高,血清EPO水平与早产儿脑损伤密切相关。ObjectiveTo study the relationship between the levels of erythropoietin （EPO） in serum and brain injury in preterm infants.MethodsThree hundred and four preterm infants （gestational age： 28-34 weeks） born between October 2014 and September 2015 were enrolled in this study. Brain injury was diagnosed using cerebral ultrasound and MRI. The levels of EPO, S100 protein, neuron-speciifc enolase （NSE） and myelin basic protein （MBP） in serum were detected using ELISA. To compare the incidence of brain injury in different serum EPO levels in preterm infants, and the relationship between brain injury and serum EPO levels was analyzed.ResultsThe incidence rate of brain injury in preterm infants was 41.1% （125/304）. The incidence rate of brain injury in the low EPO level group was signiifcantly higher than that in the middle-high EPO level groups （P〈0.01）. The serum levels of S100 protein, NSE, and MBP in the brain injury groups were signiifcantly higher than in the control group （P〈0.01）. The serum EPO levels were negatively correlated with serum S100 protein concentration and NSE levels （P〈0.05）. According to the multiple logistic regression analysis, low gestational age, low birth weight, asphyxia, prolonged mechanical ventilation, anemia and low serum EPO levels were the risk factor for brain injury in preterm infants.ConclusionsThere is a higher incidence rate of brain injury in preterm infants with lower serum EPO levels. The serum EPO levels may be correlated with brain injury in preterm infants.

关 键 词：促红细胞生成素 脑损伤 危险因素 早产儿 

分 类 号：R742[医药卫生—神经病学与精神病学]