Zielke H R, Meny R G, O'Brien M J, Smialek J E, Kutlar F, Huisman T H, Dover G J
Department of Pediatrics, University of Maryland, Baltimore 21201.
N Engl J Med. 1989 Nov 16;321(20):1359-64. doi: 10.1056/NEJM198911163212003.
It has been reported that infants who die of the sudden infant death syndrome (SIDS) have elevated fetal hemoglobin levels. To test this hypothesis, we determined the level of fetal hemoglobin in dead and living infants in three different laboratories by three methods: high-performance liquid chromatography, polyacrylamide-gel electrophoresis, and cell-based immunofluorescence assays for fetal hemoglobin-containing red cells (F cells). Our infant study population consisted of 67 infants who had died of SIDS, 22 control infants examined at autopsy, and 80 living infants. The fetal hemoglobin level was not higher in the infants who had died of SIDS than in the control infants for any age group analyzed. Immunofluorescence assays for F cells were also performed in blood samples from 105 mothers of infants who had died of SIDS, 55 adult female controls, 52 fathers of infants who had died of SIDS, and 67 adult male controls. The percentage of fetal hemoglobin-containing red cells in the parents of infants who had died of SIDS was not statistically different from that in sex-matched adults in the control groups. We conclude that elevated fetal hemoglobin levels in infants or their parents are not suitable for use as indicators of the risk of SIDS in the infants. Furthermore, the fetal hemoglobin level is not useful as a postmortem marker of an infant's having died of SIDS.
据报道,死于婴儿猝死综合征(SIDS)的婴儿胎儿血红蛋白水平升高。为验证这一假设,我们在三个不同实验室采用三种方法测定了死亡婴儿和存活婴儿的胎儿血红蛋白水平:高效液相色谱法、聚丙烯酰胺凝胶电泳法以及针对含胎儿血红蛋白红细胞(F细胞)的基于细胞的免疫荧光测定法。我们的婴儿研究群体包括67例死于SIDS的婴儿、22例尸检时检查的对照婴儿以及80例存活婴儿。在分析的任何年龄组中,死于SIDS的婴儿的胎儿血红蛋白水平均不高于对照婴儿。还对105例死于SIDS的婴儿的母亲、55例成年女性对照、52例死于SIDS的婴儿的父亲以及67例成年男性对照的血样进行了F细胞免疫荧光测定。死于SIDS的婴儿的父母中含胎儿血红蛋白红细胞的百分比与对照组中性别匹配的成年人相比无统计学差异。我们得出结论,婴儿或其父母的胎儿血红蛋白水平升高不适用于作为婴儿患SIDS风险的指标。此外,胎儿血红蛋白水平也无助于作为婴儿死于SIDS的死后标志物。