论文部分内容阅读
目的 研究窒息新生儿血小板活化状态及纤溶活性的变化 ,并探讨其临床意义。 方法 对 36例窒息新生儿及 8例正常新生儿于生后第 1天和第 4天测定血浆α-颗粒膜蛋白 (GMP- 140 )、D-二聚体及全血血小板计数。GMP- 140采用 EL ISA双抗体夹心法 ,D-二聚体采用乳胶凝集法。结果 (1)窒息组第 1天血浆 GMP- 140和 D-二聚体显著高于对照组 ,分别为 (5 2± 14) μg/ L 和 42± 9) μg/ L,(P<0 .0 5 ) ,(6 5 82± 1434 ) g/ L 和 (2 311± 85 4) g/ L(P<0 .0 1)。血小板计数明显降低 (15 2± 6 6 )×10 9/ L 和 (2 0 3± 49)× 10 9/ L(P<0 .0 5 )。第 4天两组间各值差异无显著性。(2 )血浆 GMP- 140和 D-二聚体水平的升高与窒息程度和缺氧缺血性脑病 (HIE)的严重度一致。(3)血浆 GMP- 140与 D-二聚体、BUN呈正相关 ,而与血小板数呈负相关。 结论 新生儿窒息可引起血小板活化及纤溶亢进 ,血浆GMP- 140可以作为血小板活化和破坏的指标之一 ,并可作为预测新生儿 HIE病情严重度的一项指标。
Objective To study the changes of platelet activation status and fibrinolytic activity in neonates with asphyxia and to explore its clinical significance. Methods Plasma α-granule membrane protein (GMP-140), D-dimer and whole blood platelet counts were measured in 36 neonates with asphyxia and 8 normal neonates at the first and fourth days after birth. GMP-140 using EL ISA double antibody sandwich method, D-dimer using latex agglutination. Results (1) The levels of GMP-140 and D-dimer in the asphyxia group were significantly higher than those in the control group at day 1 (52 ± 14) μg / L and 42 ± 9 (μg / L, P < 0 5), (6 5 82 ± 1434) g / L, and (2 311 ± 85 4) g / L (P 0 01). Platelet counts were significantly lower (15 2 ± 6 6) × 10 9 / L and (2 0 3 ± 49) × 10 9 / L (P <0.05). There was no significant difference between the two groups on the 4th day. (2) Elevated plasma levels of GMP-140 and D-dimer are consistent with the degree of asphyxia and the severity of hypoxic-ischemic encephalopathy (HIE). (3) Plasma GMP-140 was positively correlated with D-dimer and BUN, but negatively correlated with platelet count. Conclusion Neonatal asphyxia can cause platelet activation and hyperfibrinolysis. Plasma GMP-140 can be used as an indicator of platelet activation and destruction, and can be used as an index to predict the severity of neonatal HIE.