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目的探讨新生儿血浆血小板活化因子(PAF)水平及其乙酰水解酶(PAF-AH)活性与颅内出血(ICH)的相关性。方法选取48例ICH早产儿为出血组,48例非ICH早产儿为非出血组(根据头颅彩超结果进行诊断)。采集2组脐血、出生3 d及7 d外周静脉血,应用ELISA法检测其血浆PAF水平及PAF-AH活性,并动态观察其变化,不同组间均数比较采用单因素方差分析及两两比较,出血程度与PAF水平及PAF-AH活性行直线相关分析。结果 1.出血组血浆PAF水平均高于同期非出血组(F=219.358,P<0.01),2组脐血及出生3 d PAF水平比较差异均有统计学意义(Pa<0.01),7 d PAF水平比较差异无统计学意义(P>0.01)。出血组组内比较差异有统计学意义(F=280.135,P<0.01),颅内出血活动期(出生3 d)水平最高、出血稳定期(7 d)水平降低,二者比较差异有统计学意义(P<0.01)。2.出血组PAF-AH活性均低于非出血组(F=279.376,P<0.01),2组脐血及出生3 d水平两两比较差异均有统计学意义(Pa<0.01)、7 d时PAF-AH水平比较差异无统计学意义(P>0.01)。出血组组内比较差异有统计学意义(F=165.368,P<0.01),ICH活动期PAF-AH活性较低、稳定期PAF-AH活性升高。结论 PAF-AH活性降低及PAF水平升高为早产儿ICH的重要因素之一,而ICH的发生及转归与PAF水平、PAF-AH活性的变化有密切相关性。
Objective To investigate the relationship between plasma platelet-activating factor (PAF) and the activity of acetylhydrolase (PAF-AH) and intracranial hemorrhage (ICH) in neonates. Methods 48 cases of preterm infants with ICH were selected as bleeding group and 48 cases of non-ICH preterm infants as non-bleeding group (according to the results of skull ultrasound). Two groups of umbilical cord blood were collected and peripheral venous blood was collected on day 3 and day 7. Plasma levels of PAF and PAF-AH activity were measured by ELISA, and the changes of PAF-AH activity were observed. The mean of different groups were compared by one-way ANOVA and two- In comparison, the degree of bleeding was linearly correlated with PAF level and PAF-AH activity. PAF levels in hemorrhage group were higher than those in non-hemorrhage group (F = 219.358, P <0.01), there were significant differences in PAF level in both umbilical cord blood group and 3-day-old donor group (Pa0.01) PAF levels were no significant difference (P> 0.01). There was significant difference between the two groups (F = 280.135, P <0.01), the highest intracranial hemorrhage (3rd day of birth) and the lower hemorrhage (7th day), the difference was statistically significant (P <0.01). PAF-AH activity in hemorrhage group was lower than that in non-hemorrhage group (F = 279.376, P <0.01), there was significant difference in umbilical cord blood and 3-day level between the two groups (P <0.01) PAF-AH levels were no significant difference (P> 0.01). The difference between the two groups was statistically significant (F = 165.368, P <0.01). The activity of PAF-AH in ICH was lower and the activity of PAF-AH in stable phase increased. Conclusions The decrease of PAF-AH activity and the increase of PAF level are one of the important factors of ICH in preterm infants. The occurrence and prognosis of ICH are closely related to the changes of PAF level and PAF-AH activity.