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围产期窒息的基本生化和血液学参数及其与缺氧缺血性脑病的相关性。

Basic biochemical and hematological parameters in perinatal asphyxia and their correlation with hypoxic ischemic encephalopathy.

作者信息

Munteanu Andrei Ioan, Manea Aniko-Maria, Jinca Cristian Marius, Boia Marioara

机构信息

Department of Puericulture and Neonatology, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara , Romania.

Department of Pediatrics, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara , Romania.

出版信息

Exp Ther Med. 2021 Mar;21(3):259. doi: 10.3892/etm.2021.9690. Epub 2021 Jan 25.

Abstract

Perinatal hypoxic-ischemic encephalopathy (HIE) represents a major cause of neonatal death or long-term disability. Inflammation plays an important role in mediating brain damage induced by neonatal hypoxic-ischemic encephalopathy. The mechanisms underlying the inflammatory response in hypoxia and ischemia are complex and are still being extensively researched. The objective of this study was to determine the predictive value of peak lactate dehydrogenase (LDH), C-reactive protein (CRP), procalcitonin (PCT) and of the evolution of leukocytes, neutrophils and lymphocytes in the first 96 h after birth for the grade of encephalopathy and neurodevelopmental outcome in newborns with HIE. In order to reveal this relationship we used comparisons between the above mention parameters. The observed hematological changes were nonspecific. The vast majority of the 78 newborns included in the study had PCT values above normal in the first 24 h, contrasting with CRP values that were positive in only 15.8% of the patients. A total of 76.9% of the patients had LDH values higher than the upper limit of normal values. The mean LDH values in patients with an unfavorable prognosis were 1,235 U/l. We can conclude that LDH is a good predictor of HIE in the first 12/24 h after birth.

摘要

围产期缺氧缺血性脑病(HIE)是新生儿死亡或长期残疾的主要原因。炎症在介导新生儿缺氧缺血性脑病所致脑损伤中起重要作用。缺氧缺血时炎症反应的潜在机制复杂,仍在广泛研究中。本研究的目的是确定出生后96小时内乳酸脱氢酶(LDH)峰值、C反应蛋白(CRP)、降钙素原(PCT)以及白细胞、中性粒细胞和淋巴细胞变化对HIE新生儿脑病分级和神经发育结局的预测价值。为揭示这种关系,我们对上述参数进行了比较。观察到的血液学变化是非特异性的。该研究纳入的78例新生儿中,绝大多数在出生后24小时内PCT值高于正常,而CRP值仅15.8%的患者呈阳性。共有76.9%的患者LDH值高于正常值上限。预后不良患者的平均LDH值为1235 U/l。我们可以得出结论,LDH是出生后12/24小时内HIE的良好预测指标。

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