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氧诱导性视网膜病变:肝素无不良影响。

Oxygen-induced retinopathy: lack of adverse heparin effect.

作者信息

Higgins R D, Phelps D L

机构信息

University of Rochester Medical Center, Department of Pediatrics, New York 14642.

出版信息

Pediatr Res. 1990 Jun;27(6):580-2. doi: 10.1203/00006450-199006000-00008.

Abstract

Retinopathy of prematurity is a disorder of abnormal retinal vascular proliferation, and one hypothesis for its pathogenesis involves abnormal activity of angiogenic growth factors in the retina. One of these, acidic fibroblast growth factor, is found primarily in retina and brain tissues. Its mitogenic effect is greatly potentiated in vitro by heparin. Because retinopathy of prematurity occurs most often in premature infants who receive the greatest amount of heparin, we tested the hypothesis that heparin may adversely affect the retinopathy observed in kittens after hyperoxic (80% oxygen) exposure. Seventeen litters of kittens were randomly assigned to receive either saline or heparin s.c. injections from d 2 through recovery to 28 d of age; 65 h of high oxygen exposure was started on d 3 to induce a standard retinal injury in our model. There were no differences in the degree of retinopathy between the heparin-treated group [severity score 5.9 +/- 2.2 (mean +/- SD)], and the saline-treated group (severity score 7.1 +/- 1.7, p greater than 0.20, 80% power to detect a 2-point difference in score at alpha = 0.05). These findings do not support a concern that clinical doses of heparin potentiate retinopathy of prematurity.

摘要

早产儿视网膜病变是一种视网膜血管异常增生的疾病,其发病机制的一种假说是视网膜中血管生成生长因子的异常活性。其中一种,即酸性成纤维细胞生长因子,主要存在于视网膜和脑组织中。其促有丝分裂作用在体外被肝素大大增强。由于早产儿视网膜病变最常发生在接受最大剂量肝素的早产儿中,我们测试了肝素可能对高氧(80%氧气)暴露后的小猫视网膜病变产生不利影响的假说。将17窝小猫随机分为两组,从出生后第2天到恢复至28日龄,分别皮下注射生理盐水或肝素;在第3天开始进行65小时的高氧暴露,以在我们的模型中诱导标准的视网膜损伤。肝素治疗组的视网膜病变程度[严重程度评分5.9±2.2(平均值±标准差)]与生理盐水治疗组(严重程度评分7.1±1.7,p大于0.20,在α=0.05时检测评分2分差异的检验效能为80%)之间没有差异。这些发现不支持临床剂量肝素会加重早产儿视网膜病变这一担忧。

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