早产儿血清促红细胞生成素水平与脑损伤的关系

Relationship between serum erythropoietin levels and brain injury in preterm infants

摘要:

目的 探讨早产儿血清促红细胞生成素（EPO）水平与脑损伤的关系。方法 选取2014 年10月至2015 年9 月出生胎龄在28~34 周的早产儿304 例作为研究对象。采用颅脑B 超和MRI 检查诊断脑损伤，ELISA 检测血清EPO、S100 蛋白、神经元特异性烯醇化酶（NSE）和髓鞘碱性蛋白（MBP）水平，比较不同血清EPO 水平早产儿脑损伤的发生率，分析血清EPO 水平与各指标的相关性；采用多因素Logistic 回归分析研究血清EPO 水平与脑损伤的关系。结果 304 例早产儿中发生脑损伤125 例（41.1%）；低水平EPO 组缺血性脑损伤发生率明显高于中高水平EPO 组（P < 0.01）；脑损伤早产儿血清S100 蛋白、NSE、MBP 水平均高于无脑损伤组（P < 0.01）；血清EPO 水平与S100 蛋白浓度、NSE 水平均呈负相关（P < 0.05，P < 0.01）；Logistic 回归分析显示低胎龄、低出生体重、窒息复苏、机械通气时间延长、贫血和低血清EPO 水平均是脑损伤发病的独立危险因素。结论 血清EPO 低水平的早产儿脑损伤发生率高，血清EPO 水平与早产儿脑损伤密切相关。

Abstract:

Objective To study the relationship between the levels of erythropoietin (EPO) in serum and brain injury in preterm infants. Methods Three hundred and four preterm infants (gestational age: 28-34 weeks) born between October 2014 and September 2015 were enrolled in this study. Brain injury was diagnosed using cerebral ultrasound and MRI. The levels of EPO, S100 protein, neuron-specific enolase (NSE) and myelin basic protein (MBP) in serum were detected using ELISA. To compare the incidence of brain injury in different serum EPO levels in preterm infants, and the relationship between brain injury and serum EPO levels was analyzed. Results The incidence rate of brain injury in preterm infants was 41.1% (125/304). The incidence rate of brain injury in the low EPO level group was significantly higher than that in the middle-high EPO level groups (P < 0.01). The serum levels of S100 protein, NSE, and MBP in the brain injury groups were significantly higher than in the control group (P < 0.01). The serum EPO levels were negatively correlated with serum S100 protein concentration and NSE levels (P < 0.05). According to the multiple logistic regression analysis, low gestational age, low birth weight, asphyxia, prolonged mechanical ventilation, anemia and low serum EPO levels were the risk factor for brain injury in preterm infants. Conclusions There is a higher incidence rate of brain injury in preterm infants with lower serum EPO levels. The serum EPO levels may be correlated with brain injury in preterm infants.