血清纤溶酶原激活物诊断新生儿窒息的临床意义

摘要

Objective To evaluate the clinical implications of serum plasminogen activator detection for neonatal asphyxia assessment,and to provide a new method for the clinical diagnosis of neonatal asphyxia. Methods Sixty﹣four cases of full﹣term neonates with asphyxia were selected in the Neonatology Department of our hospital during January 2012 and June 2013,and 20 cases of healthy full﹣term newborns were selected as controls over the same period.Serum tissue plasminogen activator (t﹣PA)and plasminogen activator inhibitor ﹣1 (PAI﹣1 )levels were detected by enzyme﹣linked immunosorbent assay.Differences in serum t﹣PA and PAI﹣1 levels between the neonatal asphyxia and control groups were examined,and correlations between the two markers and Apgar score were analyzed. Results Serum t﹣PA and PAI﹣1 levels of the mild asphyxia group,severe asphyxia group,and the control group were statistically significant different.The mild asphyxia group had significantly higher levels of serum t﹣PA and PAI﹣1 than the control group,and the severe asphyxia group had higher levels of the two markers than the mild asphyxia group and the control group.Negative correlations between serum t﹣PA and PAI﹣1 levels with Apgar score were observed (r1 =-0.587 and r2 =-0.407,respectively). Conclusion Serum t﹣PA and PAI﹣1 expression levels may be used as indicators for neonatal asphyxia assessment.%目的：探讨血清纤溶酶原激活物对新生儿窒息病情评估的临床意义，为新生儿窒息提供一种客观的临床诊断方法。方法选取2012年1月—2013年6月于本院新生儿科就诊并住院治疗的足月窒息新生儿64例，根据疾病严重度分为轻度窒息组（n ＝34）和重度窒息组（n ＝30），同时选取同期足月健康新生儿20例为对照组。采用酶联免疫吸附试验检测3组血清组织型纤溶酶原激活物（t﹣PA）、纤溶酶原激活物抑制剂﹣1（PAI﹣1）的含量进行比较，并分析 t﹣PA、PAI﹣1含量与 Apgar 评分的相关性。结果3组血清 t﹣PA 和 PAI﹣1含量，差异有统计学意义；轻度窒息组血清 t﹣PA 和 PAI﹣1含量[（35．8±2．9）ng／ml、（40．2±3．6）ng／ml]高于对照组[（19．2±2．2）ng／ml、（24．1±2．3）ng／ml]，重度窒息组患儿血清 t﹣PA 和 PAI﹣1含量[（41．4±2．6）ng／ml、（64．2±3．9）ng／ml]高于轻度窒息组和对照组，差异均有统计学意义；血清 t﹣PA、PAI﹣1含量与患儿 Apgar 评分负相关（r1＝－0．587；r2＝－0．407）。结论窒息新生儿的血清 t﹣PA、PAI﹣1的表达增高，并随着窒息程度的增加，其水平递增。血清 t﹣PA、PAI﹣1可作为新生儿窒息病情评估的指标，对临床完善新生儿窒息的诊断具有重要意义。