Goel Manjusha, Dwivedi Rashmi, Gohiya Poorva, Hegde Deeparaj
Department of Paediatrics, Gandhi Medical College, Bhopal, Madhya Pradesh, India.
Department of Neonatology, Lokmanya Tilak Municipal Medical College, Sion (West), Mumbai, Maharashtra, India.
J Clin Neonatol. 2013 Oct;2(4):179-82. doi: 10.4103/2249-4847.123097.
Perinatal asphyxia is a major cause of neurological morbidity and mortality in India. The purpose of this study was to investigate variations in nucleated red blood cell (NRBC) in blood associated with perinatal asphyxia and its relationship to both the severity and short term prognosis of asphyxia.
A prospective (case-control) study was undertaken at Gandhi Medical College and Associated Hospitals. A total of 100 neonates were included in the study. Levels of NRBC/100 white blood cells (WBC) and absolute NRBC counts in cord blood were compared for 50 asphyxiated (case group) and 50 normal neonates (control group). These parameters were also related to the severity of asphyxia and clinical outcome.
The number of NRBC/100 WBC in the blood of 50 newborns each in the asphyxiated and in the control group were mean 29.5 ± 26.0, range 7-144 NRBCs/100 WBC and mean ± standard deviation 5.9 ± 2.6, range 3-14 NRBCs/100 WBC respectively (P < 0.01). Using quartile deviation, staging of hypoxic ischemic encephalopathy (HIE) was done on basis of NRBC count and there was 80% agreement between clinical and NRBC staging of HIE. There was a significant (P < 0.01) correlation of the number of NRBC\100 WBC with Apgar scoring, HIE staging and mortality.
The NRBCs/100 WBCs can be used as a simple marker for the assessment of severity and early outcome of perinatal asphyxia.
围产期窒息是印度神经疾病发病和死亡的主要原因。本研究旨在调查与围产期窒息相关的血液中有核红细胞（NRBC）的变化及其与窒息严重程度和短期预后的关系。
在甘地医学院及附属医院进行了一项前瞻性（病例对照）研究。共有100例新生儿纳入研究。比较了50例窒息新生儿（病例组）和50例正常新生儿（对照组）脐带血中NRBC/100白细胞（WBC）水平及NRBC绝对计数。这些参数还与窒息严重程度和临床结局相关。
窒息组和对照组各50例新生儿血液中NRBC/100 WBC数量分别为均值29.5±26.0，范围7 - 144个NRBC/100 WBC，以及均值±标准差5.9±2.6，范围3 - 14个NRBC/100 WBC（P < 0.01）。采用四分位数偏差，根据NRBC计数对缺氧缺血性脑病（HIE）进行分期，HIE临床分期与NRBC分期的一致性为80%。NRBC\100 WBC数量与阿氏评分、HIE分期及死亡率存在显著（P < 0.01）相关性。
NRBC/100 WBC可作为评估围产期窒息严重程度和早期结局的简单标志物。
