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目的评估血浆铁相关抗氧化物(铜蓝蛋白、转铁蛋白及铁蛋白)对于早产儿脑室周围-脑室内出血(PVH-IVH)的预测价值。方法选取2009年8月-2010年10月胎龄≤32周住院早产儿60例,均于出生3～7 d行头颅MRI检查,根据头颅MRI检查结果将60例早产儿分为2组:PVH-IVH组(21例)为头颅MRI显示PVH-IVH早产儿,对照组39例为头颅MRI显示无PVH-IVH早产儿。所有早产儿于出生24 h内检测血浆铁蛋白、转铁蛋白和铜蓝蛋白,回顾性分析比较2组临床资料及检测结果。应用SPSS 15.0软件进行统计学分析。结果 1.胎龄≤32周早产儿PVH-IVH发生率为35%(21例),按Papile分级法将PVH-IVH进行分级:Ⅰ度5例,Ⅱ度10例,Ⅲ度4例,Ⅳ度2例。2.PVH-IVH组血浆转铁蛋白水平显著低于对照组(P<0.05);PVH-IVH组血浆铜蓝蛋白水平显著低于对照组(P<0.05);2组血浆铁蛋白水平比较差异无统计学意义(P>0.05)。结论早产儿PVH-IVH早期血浆抗氧化物转铁蛋白、铜蓝蛋白水平明显低下,检测血浆抗氧化物转铁蛋白、铜蓝蛋白对预测早产儿PVH-IVH有一定价值。
Objective To evaluate the predictive value of plasma iron-related anti-oxidants (ceruloplasmin, transferrin and ferritin) in the detection of periventricular-intraventricular hemorrhage (PVH-IVH) in preterm infants. Methods Sixty preterm infants with gestational age≤32weeks from August 2009 to October 2010 were examined by cranial MRI at 3-7 days of age. According to the result of cranial MRI examination, 60 preterm infants were divided into two groups: PVH -IVH group (21 cases) showed MRI of the head in PVH-IVH preterm infants and 39 cases of control group showed no PVH-IVH preterm infants on head MRI. Plasma ferritin, transferrin and ceruloplasmin were detected in all preterm infants within 24 hours of birth, and the clinical data and test results of two groups were retrospectively analyzed. SPSS 15.0 software was used for statistical analysis. The incidence of PVH-IVH was 35% (21 cases) in preterm infants of gestational age≤32weeks. PVH-IVH was graded according to Papile grading: grade I was 5, grade II was 10, grade III was 4, and grade IV Degree in 2 cases. The level of plasma transferrin in PVH-IVH group was significantly lower than that in control group (P <0.05); the level of ceruloplasmin in PVH-IVH group was significantly lower than that in control group (P <0.05); The level of plasma ferritin in PVH-IVH group was significantly lower than that in control group No statistical significance (P> 0.05). Conclusion Early plasma PVH-IVH early plasma anti-oxidants transferrin and ceruloplasmin levels were significantly lower, detection of plasma anti-oxidants transferrin and ceruloplasmin in the prediction of preterm children with PVH-IVH has some value.