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胎儿生长受限中的神经和心脏损伤标志物及其与围产期结局的关系。

Neural and cardiac injury markers in fetal growth restriction and their relation to perinatal outcomes.

作者信息

Yakıştıran Betül, Katlan Doruk Cevdi, Yüce Tuncay, Koç Acar

机构信息

University of Health Sciences, Ankara Zekai Tahir Burak Woman's Health Training and Research Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey.

İstanbul Süleymaniye Women's Health Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey.

出版信息

Turk J Obstet Gynecol. 2019 Mar;16(1):50-54. doi: 10.4274/tjod.galenos.2019.84665. Epub 2019 Mar 27.

Abstract

OBJECTIVE

To compare the levels of umbilical cord blood Neuron-Specific Enolase (NSE) and troponin T and venous blood gas samples between healthy newborns and growth-retarded fetuses with impaired Doppler velocity or low APGAR scores.

MATERIALS AND METHODS

This study was a prospective cohort study. The study group comprised 26 patients with intrauterine growth restriction and pathologic Doppler symptoms, and the control group included 24 healthy fetuses. Umbilical cord blood and blood gas samples were taken from all patients. The blood samples were centrifuged and sent to a laboratory to study NSE and troponin T Perinatal outcomes were evaluated from the medical records of the newborns.

RESULTS

Both groups were similar in terms of demographic characteristics. Fetuses with fetal growth restriction (FGR) were born earlier and had lower APGAR scores than the study group. Chronic hypoxemic fetuses in the study group had lower cord pH and HCO levels. Further, troponin T levels were higher in the study group than in the control group. There were no major differences in Doppler velocity measurements.

CONCLUSION

It has been understood that cardiac and neuronal injury detection on fetuses with FGR, troponin T, and NSE are indicators that can be used. In the literature there are studies with heterogeneous paradigms using different indicators to find neuronal injury. As a result of this study, it is clear that to assess neonatal prognosis, wider-scoped and comparative studies will provide more information about the subject.

摘要

目的

比较健康新生儿与多普勒速度受损或阿氏评分低的生长受限胎儿之间的脐带血神经元特异性烯醇化酶(NSE)和肌钙蛋白T水平以及静脉血气样本。

材料与方法

本研究为前瞻性队列研究。研究组包括26例患有宫内生长受限和病理性多普勒症状的患者,对照组包括24例健康胎儿。采集所有患者的脐带血和血气样本。将血样离心后送至实验室研究NSE和肌钙蛋白T。从新生儿的病历中评估围产期结局。

结果

两组在人口统计学特征方面相似。胎儿生长受限(FGR)的胎儿出生更早,阿氏评分低于研究组。研究组中的慢性低氧血症胎儿脐带血pH值和HCO水平较低。此外,研究组的肌钙蛋白T水平高于对照组。多普勒速度测量无重大差异。

结论

已了解到,对于FGR胎儿,肌钙蛋白T和NSE是可用于检测心脏和神经元损伤的指标。文献中有使用不同指标寻找神经元损伤的异质性范式的研究。本研究结果表明,为评估新生儿预后,范围更广的比较性研究将提供有关该主题的更多信息。

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