尿8-异前列腺素F_(2α)测定在新生儿缺氧缺血性脑病病情评估中的价值(英文)

Value of urine 8-iso-PGF2αin the assessment of the severityof neonatal hypoxic-ischemic encephalopathy

摘要:

目的：测定新生儿尿8-异前列腺素F2α(8-iso-PGF2α)水平，分析其在缺氧缺血性脑病（HIE）患儿病情评估中的价值。方法：分别于生后1 d、3 d和7d收集正常（n = 126）和HIE（n = 151）新生儿尿液，应用ELISA法检测其8-iso-PGF-2α含量。结果：①正常新生儿生后1、3和7d的尿8-iso-PGF2α水平分别为29.9±7.9、27.7±9.8和27.5±10.5 ng/mmol·Cr，差异无统计学意义；②病程第1 d，轻、中和重度HIE患儿尿8-iso-PGF2α水平分别为65.3±13.2、154.6±31.6和241.7±41.0 ng/mmol·Cr，差异具有显著性意义，且均高于正常新生儿水平(P＜0.001)；③病程第3 d，中度和重度HIE患儿8-iso-PGF2α水平（34.2±10.3ng/mmol·Cr 、50.8±12.8 ng/mmol·Cr）仍高于正常新生儿(P＜0.001），而轻度HIE患儿尿8-iso-PGF2α水平下降至正常新生儿水平；④病程第7 d，轻、中和重度HIE及正常新生儿之间的8-iso-PGF-2α水平无明显差异；⑤以8-iso-PGF2α水平45.5、89.9 和217.5 ng/mmol·Cr作为区分正常与轻度HIE、轻度与中度HIE、中度与重度的界限，其敏感性和特异性分别为95.2%和99.2%，100%和95.2%，65.8%和 100%。结论：生后7d内正常新生儿尿8-iso-PGF2α水平相对稳定；HIE患儿尿中8-iso-PGF2α峰值于病程第1 d出现，其升高程度与病情严重程度相关，是一项评估患儿病情可靠而简便的生化指标。［中国当代儿科杂志，2005, 7(2):103-106］

Abstract:

OBJECTIVE: It was aimed to determine the concentration of urine 8-iso-PGF_ 2α in normal neonates and neonates with hypoxic-ischemic encephalopathy (HIE) and to study the value of urine 8-iso-PGF_ 2α in the assessment of the severity of neonatal HIE. METHODS: Urine samples from normal (n=126) and HIE (n=151) neonates were collected on the 1st, 3rd and 7th days after birth. ELISA was used to determine the urine 8-iso-PGF_ 2α contents. RESULTS: 1) Urine 8-iso-PGF_ 2α contents from normal neonates were 29.9 ± 7.9, 27.7 ± 9.8 and 27.5 ± 10.5 ng/mmol·Cr on the 1st, 3rd and 7th days after birth, respectively. There was no significant difference among the three days for the urine 8-iso-PGF_ 2α contents. 2) On the 1st day of HIE onset, neonates with mild, moderate and severe HIE had higher levels of urine 8-iso-PGF_ 2α (65.3 ± 13.2, 154.6 ± 31.6 and 241.7 ± 41.0 ng/mmol·Cr, respectively) compared with the normal neonates (P﹤0.001 ). 3) On the 3rd day, the urine 8-iso-PGF_ 2α content in neonates with moderate and severe HIE remained higher (34.2 ± 10.3 and 50.8 ± 12.8 ng/mmol·Cr, respectively) than the normal neonates (P﹤0.001 ), while that of the neonates with mild HIE regressed to normal. 4) On the 7th day, there was no significant difference in the urine 8-iso-PGF_ 2α level between all HIE and normal neonates. 5) The boundaries of 45.5, 89.9 and 217.5 ng/mmol·Cr of urine 8-iso-PGF_ 2α were defined to distinguish from normal to mild HIE, from mild to moderate HIE and from moderate to severe HIE. As defined, the corresponding sensitivity and specificity were 95.2% and 99.2%, 100% and 95.2%, 65.8% and 100%. CONCLUSIONS: The urine 8-iso-PGF_ 2α levels in neonates were stable within 7 days after birth. The urine 8-iso-PGF_ 2α contents in HIE neonates reached the peak within 24 hours after onset. There was a correlation between the urine 8-iso-PGF_ 2α contents and the severity of HIE, suggesting that urine 8-iso-PGF_ 2α may be a reliable and convenient index for the assessment of the severity of HIE.