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目的探讨脐血8-异前列腺素(8-iso-PGF2a)评估晚期早产儿及足月新生儿窒息程度及窒息后缺血缺氧性脑病(HIE)的可靠性。方法收集轻度窒息的晚期早产儿及足月新生儿30例,重度窒息晚期早产儿及足月新生儿20例,30例同期产科分娩的正常晚期早产儿及足月新生儿作为对照组,以及生后3d内诊断为新生儿缺氧缺血性脑病的重度窒息患儿12例。用酶联免疫吸附法(ELISA)测定各组新生儿脐静脉血8-iso-PGF2a水平。结果窒息组与无窒息组相比,8-iso-PGF2a水平明显升高。两组比较,有统计学意义(t=5.898,P<0.01)。与轻度窒息组相比,重度窒息组8-iso-PGF2a水平明显升高。两组比较有统计学差异(t=24.86,P<0.01)。窒息组中发生新生儿缺氧缺血性脑病(HIE)与未发生HIE者比较,脐血8-iso-PGF2a显著升高,两组比较差异有统计学意义(t=4.97,P<0.01)。结论脐血8-iso-PGF2a水平与晚期早产儿及足月新生儿窒息相关,晚期早产儿及足月新生儿窒息程度越严重,脐血8-iso-PGF2a水平越高,因此,脐血8-iso-PGF2a水平可用来评估晚期早产儿及足月新生儿窒息的短期预后。
Objective To investigate the evaluation of 8-iso-PGF2a in umbilical cord blood on the degree of asphyxia in neonates with advanced preterm infants and term neonates with asphyxia and the reliability of hypoxic ischemic encephalopathy (HIE) after asphyxia. Methods Thirty newborns with term asphyxia and full term newborns, 30 late preterm infants with severe asphyxia, 20 full term newborns and 30 normal newborns with full term obstetric birth and full term newborns were enrolled as control group. 12 cases of severe asphyxia in neonates with hypoxic-ischemic encephalopathy diagnosed after birth. The levels of 8-iso-PGF2a in neonatal umbilical vein were determined by enzyme-linked immunosorbent assay (ELISA). Results Asphyxia group compared with no asphyxia group, 8-iso-PGF2a levels were significantly higher. The two groups were statistically significant (t = 5.898, P <0.01). Compared with mild asphyxia group, severe asphyxia group 8-iso-PGF2a levels were significantly higher. There was a significant difference between the two groups (t = 24.86, P <0.01). Compared with those without HIE, 8-iso-PGF2a in cord blood increased significantly in asphyxia group (t = 4.97, P <0.01) . Conclusion The level of 8-iso-PGF2a in umbilical cord blood is associated with asphyxia in late preterm infants and full term newborns, asphyxia in late preterm infants and term infants is more severe, and the level of 8-iso-PGF2a in umbilical cord blood is higher. Therefore, umbilical cord blood 8 The -iso-PGF2a level can be used to assess the short-term prognosis of asphyxia in late preterm infants and term neonates.