新生儿缺氧缺血性脑病血浆D-二聚体的动态观察

Dynamic Variation of Plasma D-dimer Levels in Neonates with Hypoxic-ischemic Encephalopathy

摘要:

目的 探讨D -二聚体在新生儿缺氧缺血性脑病 (HIE)中的变化和临床意义。方法 采用胶乳凝集法测定 40例HIE患儿和 2 0例健康对照新生儿急性期和恢复期血中D -二聚体水平 ,同时观察了全身炎症反应综合征 (SIRS)的发生率。结果 HIE急性期患儿的D -二聚体水平明显高于恢复期 (3 .5 0± 0 .2 0 )mg/L对 (0 .42± 0 .0 4)mg/L ;(8.2 0± 0 .35 )mg/L对 (3 .0 0± 0 .2 0 )mg/L (P <0 .0 1) ,也明显高于正常对照 (P <0 .0 1)。中、重度明显高于轻度和对照 (0 .2 6± 0 .0 3)mg/L (P <0 .0 1) ,轻度与对照无明显差异 (P >0 .0 5 )。D -二聚体水平与SIRS的发生率呈正相关 (r =0 .987)。结论 D -二聚体在HIE的病理过程中起重要的作用 ,可作为快速诊断、判断预后、治疗效果的参考指标

Abstract:

Objective To explore the changes of plasma D-dimer levels and their clinical implication in neonates with hypoxic-ischemic encephalopathy (HIE). Methods We measured the dynamic variations of plasma D-dimer levels in 40 neonates with HIE and 20 normal controls using the latex agglutination method and observed the incidence of the systemic inflammatory response syndrome (SIRE). Results The plasma D-dimer level markedly increased in the acute stage of HIE compared with the remission phase, especially in the moderate and severe groups ( 3.50 ± 0.20 ) mg/L vs. ( 0.42 ± 0.04 ) mg/L; ( 8.20 ± 0.35 ) mg/L vs. ( 3.00 ± 0.20 ) mg/L, respectively (P< 0.01 ), and the D-dimer levels were much higher than those of the normal controls (0.26±0.03) mg/L, (P< 0.01 ). There was no difference between the milds and the controls. The plasma D-dimer levels and the incidence of SIRS were positively correlated (r= 0.987 ). Conclusions Plasma D-dimer may play an important role in the pathologic process in HIE and it may be of use as an index in the diagnosis, treatment and prognosis of HIE. [