Objective:To investigate the effect of asphyxia on erythrocyte parameters in preterm infants, and whether nucleated red blood cells (NRBC) can predict hypoxic brain damage and prognosis in premature infants. Methods:Fifity asphyxia premature infants with brain injury and 30 asphyxia premature infants without brain injury were selected as observation group, and 20 preterm infants as control group from June 2015 to May 2017. Blood routine red blood cell parameters were detected at different time points in the two groups. We also had MRI, amplitude integrated electroencephalogram and head color Doppler examination. The brain damage in preterm infants was observed dynamically. Results:The number of red blood cells (RBC), HGB, HCT had no statistical significance between the observation group and the control group (P>0.05). NRBC and NRBC% of the observation group were significantly higher than that in the control group (P<0.05); Amplitude integrated electroencephalogram (Co) EEG continuity, sleep wake cycle (Cy) and edge amplitude (LB) of the observation group were significantly lower than the control group (P<0.05). The cerebral blood flow velocity of the observation group was significantly lower than that of the control group (P<0.05). The NRBC parameters returned to normal in 12 months after birth, and the percentage of brain injury decreased significantly (P<0.05). The increase of NRBC was positively correlated with the degree of asphyxia. The level of NRBC was positively correlated with the degree of asphyxia preterm infants. Conclusion:The degree of NRBC elevation in asphyxiated premature infants is associated with the degree of asphyxia. The time of NRBC returned to normal in asphyxia premature infants is positively correlated with the recovery time of cranial imaging and EEG abnormality. It can be used as an index to predict the degree and prognosis of brain injury. |
[1] FOTTRELL E,OSRIN D,ALCOCK G,et al.Cause-specific neonatal mortality:analysis of 3772 neonatal deaths in Nepal,Bangladesh,Malawi and India[J].Arch Dis Child Fetal Neonatal Ed,2015,100(5):F439-F447.
[2] JBRYCE J,BOSCHIPINTO C,SHIBUYA K,et al.WHO estimates of the causes of death in children[J].The Lancet,2005,365(9465):1147-1152.
[3] LINCETTO O,WHO Geneve.Birth asphyxia-summary of the previous meeting and protocol overview[C].Milano,2007.
[4] 中国医师协会新生儿专业委员会.新生儿窒息诊断和分度标准建议[J].中国当代儿科杂志,2013,15(1):1.
[5] MORALES P,BUSTAMANTE D,ESPINA-MARCHANT P,et al.Pathophysiology of perinatal asphyxia:can we predict and improve individual outcomes?[J].EPMA J,2011,2(2):211-230.
[6] 郝玲,邓彦东,王娜,等.窒息早产儿脑血流变化及其与脑损伤的关系[J].中国妇幼保健,2013,28(24):3938-3940.
[7] BURDJALOV V F,BAUMGART S,SPITZSER A R.Cerebral function monitoring:A new system for the evaluation of brain maturation in neonates[J].Pediatrics,2003,112(4):855-861.
[8] 孟淑英,张可冰.有核红细胞预测缺氧缺血性脑病严重程度和预后的价值[J].中国小儿急救医学,2013,20(2):186-187.
[9] 谢露,陈洪清,杨尧,等.有核红细胞预测围产期窒息严重度和短期预后的价值[J].中华临床医师杂志:电子版,2011,5(23):7140-7143.
[10] SARNAT H B,SARNAT M S.Neonatal encephalopathy following fetal distress.A clinical and electroencephalographic study[J].Arch Neurol,1976,33(10):696-705.
[11] ROBERTSON C M,PERLMAN M.Follow-up of the term infant after hypoxic-ischemic encephalopathy[J].Paediatr Child Health,11(5):278-282.
[12] 李春亮,劳晓玲,莫洁洁,等.围产期窒息新生儿严重高乳酸血症快速清除治疗研究[J].临床医学,2016,12(36):44-46.
[13] MEMON S,SHAIKH S,BIBI S.To compare the outcome(early)of neonates with birth asphyxia in-relation to place of delivery and age at time of admission[J].J Pak Med Assoc,2012,62(12):1277-1281. |