新生儿中—重度缺氧缺血性脑病血浆褪黑素水平的研究

发布时间：2018-02-16 20:32

  本文关键词： 褪黑素 中-重度新生儿缺氧缺血性脑病 新生儿　出处：《山西医科大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的： 新生儿缺氧缺血性脑病(hypoxic-ischemic encephalopathy，HIE)是指在产前、产时、产后由于各种原因的缺氧窒息，导致新生儿脑的缺氧缺血性损害。因其可引起神经系统的伤残，是新生儿疾病当中危害最大的常见病之一。即使在欧美等发达国家，新生儿缺氧缺血性脑病发病率约1‰～2‰，中重度HIE的死亡和严重伤残率也高达53％～61％，中重度患儿如果能有幸存活下来，常常会留有程度不等、表现各异的神经系统后遗症，如脑性瘫痪、癫痫、智力低下等。本文研究新生儿中-重度缺氧缺血性脑病血浆褪黑素( Melatonin , MLT )水平的变化,期望为褪黑素应用于临床，治疗新生儿缺氧缺血性脑病提供一定的实验证据。 对象与方法： 1.1研究对象选择山西省儿童医院新生儿内科，2010年5月至2010年11月住院的0～3天足月新生儿中-重度新生儿缺氧缺血性脑病20例,其中男12例,女8例。平均体重2990±312.74g ,平均胎龄39.5土1.12周。新生儿缺氧缺血性脑病的临床诊断，，依据2004年11月在湖南长沙举办的“全国新生儿缺氧缺血性脑病学术会议”进一步修订的临床诊断及分度标准。对照组选择同时间住院的20例足月新生儿，该组新生儿要求母亲怀孕期间健康，无妊娠期糖尿病、高血压等合并症，患儿自身则要求无围产期窒息史、无宫内发育迟缓、未患有感染性、代谢性疾病。其中男10例,女10例。平均体重3050±502.44g ,胎龄39.3土1.65周。实验组和对照组两组新生儿在胎龄、出生体重、性别、采血时间等组成上经过分析后差别无统计学意义。 1.2方法HIE患儿于入院当天（生后0～3天、急性期）、恢复期（生后7～10天），20例对照患儿于出生后0～3天、7～10采血。所选实验患儿均于上午10时左右经股静脉采取静脉血2ml ,所采血样先保存于不含抗凝剂的玻璃试管中,1小时内在低温高速离心机下，2000转/分钟离心半小时,然后用移液器留取上层血浆0.5毫升，保存在聚乙烯管中,放置于- 20℃冰箱中保存。采用酶联免疫吸附试验选定同一时间内检测血浆褪黑素水平。 1.3统计学方法血浆褪黑素值以均数±标准差（x±s）表示。两组数据之间比较采用SPSS13.0统计学软件包，进行两组独立样本的秩和检验。制定检验水准P0.05差异有统计学意义。 结果： 新生儿中-重度缺氧缺血性脑病与对照组相比,血浆褪黑素水平在中-重度HIE急性期时与对照组差异无统计学意义,而在恢复期时则显著高于对照组。正常对照新生儿组0～3天与7～10天时比较差异无统计学意义，而中-重度缺氧缺血性脑病新生儿恢复期时，血浆褪黑素水平明显高于急性期。 结论： 新生儿窒息后并发中重度缺氧缺血性脑病时，在其恢复期血浆褪黑素水平升高,提示褪黑素对于缺氧缺血性大脑有一定的保护作用。
[Abstract]:Objective:
Neonatal hypoxic ischemic encephalopathy (hypoxic-ischemic encephalopathy HIE) refers to the prenatal, intrapartum, postpartum due to various reasons lead to hypoxia asphyxia, neonatal hypoxic ischemic injury of the brain. Because of the cause of neurological disability, neonatal disease is one of the common diseases harm. Even in Europe and other developed countries, the incidence of neonatal hypoxia ischemic encephalopathy rate of about 1 per thousand to 2 per thousand, moderate to severe HIE death and severe disability rate is as high as 53% ~ 61%, moderate and severe groups if lucky enough to survive, often have varying degrees of neurological sequelae, varied manifestations, such as cerebral palsy, epilepsy, mental retardation and so on. This paper studies in the newborn plasma melatonin - severe hypoxic ischemic encephalopathy (Melatonin, MLT) level of melatonin expectations for the clinical application in the treatment of hypoxic ischemic brain disease of the newborn to provide a real Proof.
Objects and methods:
1.1 study of neonatal medicine, children's Hospital of Shanxi Province, 0~3 days from May 2010 to November 2010 were full-term newborns in severe neonatal hypoxic ischemic encephalopathy in 20 cases, male 12 cases, female 8 cases. The average weight of 2990 + 312.74g, the average gestational age of 39.5 soil for 1.12 weeks. Clinical diagnosis of neonatal hypoxic ischemic encephalopathy, clinical basis the diagnosis and grading standards held in Hunan in November 2004 Changsha "National Conference on neonatal hypoxic ischemic encephalopathy" further amended. 20 cases of full-term newborns in control group with time in hospital, the neonates requirements during pregnancy health, without gestational diabetes, hypertension and other complications, the child's own requires no perinatal asphyxia. No intrauterine growth retardation, not suffering from infectious, metabolic diseases. There were 10 male and 10 female patients. The average weight of 3050 + 502.44g, gestational age of 1.65 weeks. 39.3 soil experiment There was no significant difference between the two groups of newborn infants, birth weight, sex, and blood collection time, and so on.
Methods 1.2 HIE patients on admission day (0~3 days after birth, acute period), recovery period (7~10 days after birth), 20 cases of the control group on the 0~3 day after birth, 7~10 were selected. The children were in the morning 10 when the left and right sides through the femoral vein to take blood 2ml, the blood samples stored in the first glass the tube without anticoagulant, within 1 hours under low temperature and high speed centrifuge and centrifuged at 2000 rpm for half an hour, and then use the pipette specimens from the upper plasma 0.5 ml, stored in polyethylene tubes, placed in the refrigerator. - 20 C to detect plasma melatonin levels by enzyme-linked immunosorbent assay selected at the same time.
1.3 statistical method, plasma melatonin value was expressed by mean + standard deviation (x + s). The SPSS13.0 statistics software package was used to compare two groups of independent samples rank test. The difference between the two groups was statistically significant.
Result锛

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