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目的研究8-异前列腺素F2α(8-Ⅰ-PGF2α)在早产儿脑白质损伤及神经行为评价中的临床意义。方法2002年12月—2005年3月在新生儿ICU住院的46例早产儿,纠正胎龄为40周行NBNA评分;于生后48h使用头颅B超对早产儿颅内监测,根据脑室内出血程度分为正常组、轻度损伤组(Ⅰ级、Ⅱ级脑室内出血)及重度损伤组(Ⅲ级、Ⅳ级颅内出血)。ELISA法分别检测3组间脑脊液中8-I-PGF2α。结果正常组31例,NBNA评分为(39.1±0.2)分;轻度损伤组9例,NBNA评分为(37.4±1.5)分;重度损伤组6例,NBNA评分为(31.3±3.4)分(不包括放弃治疗的2例病人)。轻、重度损伤组早产儿共5例(轻度损伤组2例,重度损伤组3例),其中并伴有4例脑室周围白质软化,此5例患儿脑脊液中8-Ⅰ-PGF2α均在300pg/mL以上。通过把8-Ⅰ-PGF2α分成<150pg/mL、(150～250)pg/mL及>250pg/mL三个区间,发现<150pg/mL患儿NBNA为(38.3±1.5)分;(150～250)pg/mL患儿NBNA为(34.9±2.4)分,>250pg/mL患儿NBNA为(30.2±3.1)分。三区间NBNA评分比较有统计学意义(F=6.598,P<0.001)。结论早产儿严重的颅内出血患儿早期有脑脊液8-I-PGF2α升高,早期监测8-I-PGF2α及脑室内出血程度可能对其神经行为预后有一定的判断作用。
Objective To investigate the clinical significance of 8-iso-prostaglandin F2α (8-Ⅰ-PGF2α) in the evaluation of white matter damage and neurobehavioral in premature infants. Methods Forty-six preterm infants admitted to neonatal ICU from December 2002 to March 2005 were enrolled in this study. The NBNA score was corrected for gestational age at 40 weeks. Intracranial monitoring of preterm neonates was performed at 48 hours after birth. According to the degree of intraventricular hemorrhage Divided into normal group, mild injury group (grade Ⅰ, Ⅱ grade intraventricular hemorrhage) and severe injury group (grade Ⅲ, Ⅳ intracranial hemorrhage). The levels of 8-I-PGF2α in cerebrospinal fluid were detected by ELISA. Results NBNA score was (39.1 ± 0.2) in normal group, 9 in mild injury group (37.4 ± 1.5), 6 in severe injury group (NBNA score was 31.3 ± 3.4) Including 2 patients who gave up treatment). In mild and severe injury group, there were 5 preterm infants (2 in mild injury group and 3 in severe injury group), accompanied by 4 cases of periventricular leukomalacia. The 5-CSF levels of 8-I-PGF2α 300pg / mL or more. NBNA of <150 pg / mL was found to be (38.3 ± 1.5) min by dividing the 8-I-PGF2α into <150 pg / mL, 150-250 pg / mL and> 250 pg / mL; ) NBNA was (34.9 ± 2.4) points in pg / mL and (30.2 ± 3.1) points in children> 250pg / mL. The NBNA scores of the three groups were statistically significant (F = 6.598, P <0.001). Conclusions Early onset of severe intracranial hemorrhage in children with early cerebrospinal fluid 8-I-PGF2α increased early detection of 8-I-PGF2α and intraventricular hemorrhage may have some judgments on the neurological behavior.