治疗性低体温对围产期窒息足月新生儿 DNA 损伤和神经发育结局的影响：一项随机对照试验。

Effect of therapeutic hypothermia on DNA damage and neurodevelopmental outcome among term neonates with perinatal asphyxia: a randomized controlled trial.

机构信息

Division of Neonatology, Department of Pediatrics, Jawaharlal Institute of Post-graduate Medical Education and Research (JIPMER), Pondicherry 605 006, India.

出版信息

J Trop Pediatr. 2014 Apr;60(2):134-40. doi: 10.1093/tropej/fmt098. Epub 2013 Dec 16.

DOI:10.1093/tropej/fmt098

PMID:24343823

Abstract

OBJECTIVE

To study the effect of therapeutic hypothermia (TH) on deoxyribonucleic acid (DNA) damage and the neurodevelopmental outcome in term babies with perinatal asphyxia.

METHODS

Babies in the hypothermia group were cooled for the first 72 h, using gel packs. Rectal temperature of 33-34°C was maintained. Blood sample was collected before, at 36 h and after completion of TH for assessment of comet assay and 8-hydroxy2-deoxyguanosine (8-OHdG). Infants were followed up till 12 months.

RESULTS

Baseline parameters were similar. After 72 h, the hypothermia group showed lower olive tail moment (12.88 ± 2.14) than the control group (22.16 ± 5.26) (p < 0.001). 8-HDG levels increased significantly in the control group (1252.87 ± 357.07) as compared to the hypothermia group (757.03 ± 198.49) (p < 0.001). Neurodevelopmental assessment at 12 months showed significantly low motor and mental developmental quotient in the control than hypothermia group.

CONCLUSIONS

TH reduces oxidative stress-induced DNA damage and improves neurodevelopmental outcome. <Trial registration No: CTRI/2011/10/002094>

摘要

目的

研究治疗性低体温（TH）对围产期窒息足月婴儿脱氧核糖核酸（DNA）损伤和神经发育结局的影响。

方法

采用凝胶包对低温组婴儿进行 72 小时的首次冷却，保持直肠温度在 33-34°C。在 TH 前、36 小时和完成后采集血样，用于彗星试验和 8-羟基-2-脱氧鸟苷（8-OHdG）评估。婴儿随访至 12 个月。

结果

基线参数相似。72 小时后，低温组橄榄尾矩（12.88±2.14）低于对照组（22.16±5.26）（p<0.001）。与低温组（757.03±198.49）相比，对照组 8-HDG 水平显著升高（1252.87±357.07）（p<0.001）。12 个月时的神经发育评估显示，对照组的运动和精神发育商明显低于低温组。