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目的探讨血管内皮生长因子(VEGF)、血小板计数(PLT)在早产儿颅内出血(ICH)中的动态变化及意义。方法选取2012年12月至2013年5月山西省儿童医院急救中心新生儿重症监护病房收治的30例ICH早产儿为观察组,30例非ICH早产儿为对照组,分别采用双抗体夹心ELISA法及血细胞分析仪,动态监测2组早产儿在生后1~3天(出血活动期)、7~10天(出血稳定期)血清VEGF及PLT变化,并对VEGF与PLT进行相关性分析。结果观察组早产儿生后第1~3天、第7~10天VEGF水平(pg/ml)均明显高于对照组[(289.8±16.4)比(214.2±13.7),(319.4±15.0)比(220.2±12.7)],且出血稳定期较活动期显著升高,差异有统计学意义(P均<0.01)。观察组活动期PLT较对照组显著降低[(177.0±18.6)比(229.2±23.3)],稳定期明显升高[(271.8±27.6)比(235.9±20.2)],差异有统计学意义(P均<0.01)。观察组早产儿生后7~10天血清VEGF水平与PLT变化呈正相关(r=0.420,P<0.05)。结论血清VEGF和PLT在早产儿ICH发生后呈动态变化,且有一定的相关性,提示两者可能参与了早产儿ICH后的病理过程,动态联合检测可能对于判断早产儿ICH病情变化有一定指导意义。
Objective To investigate the dynamic changes and clinical significance of vascular endothelial growth factor (VEGF) and platelet count (PLT) in preterm infants with intracranial hemorrhage (ICH). Methods Thirty ICH preterm infants admitted to the neonatal intensive care unit of the emergency center of Children’s Hospital of Shanxi Province between December 2012 and May 2013 were selected as observation group and 30 non-ICH preterm infants as control group. And hematology analyzer. The changes of serum VEGF and PLT in 1 ~ 3 days (bleeding stage) and 7 ~ 10 days (bleeding stage) were dynamically monitored in 2 groups of preterm infants. The correlation between VEGF and PLT was also analyzed. Results The VEGF level (pg / ml) of preterm infants in observation group at 1 day to 3 days and 7 days to 10 days after birth was significantly higher than that of control group [(289.8 ± 16.4) vs (214.2 ± 13.7) vs (319.4 ± 15.0) (220.2 ± 12.7)], and the stable period of hemorrhage was significantly higher than that of active stage, the difference was statistically significant (all P <0.01). The activity of PLT in the observation group was significantly lower than that in the control group [(177.0 ± 18.6) vs (229.2 ± 23.3)], and significantly higher in the stable period [(271.8 ± 27.6) vs (235.9 ± 20.2)], P < All <0.01). The level of serum VEGF in observation group was positively correlated with PLT 7 ~ 10 days after birth (r = 0.420, P <0.05). Conclusion The serum levels of VEGF and PLT in the preterm infants after ICH occurred dynamic changes, and a certain correlation, suggesting that the two may be involved in premature children after ICH pathological process, dynamic joint detection may be useful for judging changes in preterm children with ICH guidance significance.