[有核红细胞作为新生儿脑室内出血的早期标志物]

Krajewski Paweł, Kalinka Jarosław, Welfel Ewa, Kwiatkowska Maria, Pokrzywnicka Małgorzata

Klinika Perinatologii I Katedry Ginekologii i Połoznictwa, Uniwersytetu Medycznego w Lodzi.

Ginekol Pol. 2007 Dec;78(12):961-5.

INTRODUCTION

The aim of the paper was to evaluate the usability of nucleated blood cells count in newborn infants in the first 12 hours after their birth as an early marker of intraventricular haemorrhage.

MATERIAL AND METHODS

The retrospective research included 210 newborns (both born at term??? and prematurely), delivered at the Department of Clinical Sciences of Perinatology of the I Chair of Gynecology and Obstetrics of the Medical University in Lódź, Poland from 1 January 2003 to 31 December 2006. During the first 12 hours after the birth, the abovementioned infants were diagnosed with nucleated blood cells in their blood count. The correlation between the number of nucleated blood cells and the occurrence of intraventricular haemorrhage has been investigated. Intraventicular haemorrhage was diagnosed with the use of transfontanel ultrasonography between the third and the seventh day of life. The increased number of erythroblasts was established to be on the level above 20 nucleated blood cells/100 white blood. The material was subject to statistical analysis which included the use of a Spearman's rank correlation coefficient, a chi-square test, and a Mann-Whitney test. The statistically significant level adopted equaled p<0.05.

RESULTS

Out of 210 newborns included in the survey, among 71 (33.81%) intraventricular haemorrhage were diagnosed in the first week of their life. The I and II grade haemorrhage occurred in 61 newborns, which equals 85.92%, and the III or IV grade haemorrhage occurred in 10 patients (14.08%). In case of 50 newborns with IVH (70.42%) the number of nucleated blood cells exceeded 20/100 white blood cells. The average level of erythroblast for newborns with IVH equaled 87.46 (146.49), and in the group without IVH 38.86 (7.82). In order to examine the relation between the number of nucleated blood cells and the intraventricular haemorrhage a Spearman's rank correlation coefficient was used, as well as a chi-square test and a Mann-Whitney test On their basis it was concluded that there is a statistically significant relation between the level of erythroblast and the occurrence of intraventricular haemorrhage p=0.0048.

CONCLUSIONS

The evaluation of the number of nucleated red blood cells in newborn infants can be an early, noninvasive marker of the intraventricular haemorrhage in newborns.

引言

本文旨在评估新生儿出生后12小时内核细胞计数作为脑室内出血早期标志物的可用性。

材料与方法

回顾性研究纳入了210例新生儿（包括足月儿和早产儿），这些新生儿于2003年1月1日至2006年12月31日在波兰罗兹医科大学第一妇产科围产医学临床科学系分娩。在出生后的前12小时内，对上述婴儿进行血常规检查，以诊断其中的有核血细胞。研究了有核血细胞数量与脑室内出血发生之间的相关性。在出生后第三天至第七天，通过前囟超声检查诊断脑室内出血。确定有核红细胞数量增加的标准是高于20个有核血细胞/100个白细胞。对该材料进行了统计分析，包括使用Spearman等级相关系数、卡方检验和Mann-Whitney检验。采用的统计学显著性水平为p<0.05。

结果

在纳入调查的210例新生儿中，71例（33.81%）在出生后第一周被诊断为脑室内出血。61例新生儿发生了I级和II级出血，占85.92%，10例患者（14.08%）发生了III级或IV级出血。在50例IVH新生儿（70.42%）中，有核血细胞数量超过20/100个白细胞。IVH新生儿的有核红细胞平均水平为87.46（146.49），无IVH组为38.86（7.82）。为了研究有核血细胞数量与脑室内出血之间的关系，使用了Spearman等级相关系数以及卡方检验和Mann-Whitney检验。在此基础上得出结论，有核红细胞水平与脑室内出血的发生之间存在统计学显著关系，p = 0.0048。