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目的 研究新生儿缺氧缺血性脑病(HIE)血小板活化状态,探讨其临床意义。方法 43 例HIE按病情轻重分为轻、中、重三组,并以19 例正常新生儿作为对照。血浆颗粒膜蛋白-140(GMP-140)采用ELISA双抗体夹心法测定。血小板计数采用Coul-ter-stks自动血细胞分析仪测定。结果 发病初期血浆GMP-140 显著升高,并与病情严重度一致。血浆GMP-140 与血小板数量呈负相关(n= 43,r= - 0.44 P< 0.05),轻度HIE患儿血小板数量还没有明显下降时,GMP-140 就已较对照组升高(P< 0.05),危重儿在恢复期虽然血小板数量明显上升,其GMP-140 仍高于对照组(P< 0.05)。结论 HIE患儿体内存在血小板活化,表明患儿处于血栓前状态,该指标的变化与病情的严重度一致。监测血浆GMP-140 的变化有助于血栓前状态的早期诊断、指导治疗、判断预后的指标
Objective To study the platelet activation in neonatal hypoxic-ischemic encephalopathy (HIE) and to explore its clinical significance. Methods Forty-three HIE patients were divided into mild, moderate and severe groups according to the severity of their illness. Nineteen normal neonates were used as controls. Plasma membrane protein-140 (GMP-140) was measured by ELISA double antibody sandwich method. Platelet counts were determined using a Coulter-Stark automated hematology analyzer. Results The initial stage of plasma GMP-140 was significantly increased, and consistent with the severity of the disease. Plasma GMP-140 was negatively correlated with the number of platelets (n = 43, r = - 0.44 P <0.05). The number of GMP-140 was significantly increased in children with mild HIE compared with the control group (P < 0.05). Although the number of platelets in critically ill children during convalescence increased significantly, GMP-140 was still higher than that of control group (P <0.05). Conclusion There is platelet activation in children with HIE, indicating that the patient is in a prothrombotic state. The change of this index is consistent with the severity of the disease. Monitoring changes in plasma GMP-140 contributes to the early diagnosis of prethrombotic state, guiding treatment, and prognostic indicators