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目的探讨血清表皮生长因子水平与早产儿脑发育的关系。方法对2005年8月至2006年4月连续收入上海儿童医学中心新生儿病房、出生24h内、胎龄(238±3)d的30例早产适于胎龄儿,采用酶联免疫吸附测定法(ELISA)分别测定其生后24h内(t0值)和第8天(t1值)的空腹血清EGF水平,计算其血清EGF变化速率(△t);进行床边头颅B超检查以排除颅内病变;并在校正胎龄近40周(生后6周)和1月龄时(生后10周)分别测量其头围并进行NBNA评估,计算其头围增长速率及NBNA差值。应用Pearson方法对所有测定结果分别进行相关分析。结果30例早产儿的血清EGFt0为(234.71±58.07)pg/mL,t1为(347.81±87.49)pg/mL,△t为(12.14±1.85)pg/(mL.d)。Pearson相关分析显示,2次NBNA评分结果及其差值、出生后6周和10周时的头围增长值和增长速率,均与t0值无明显相关性(P均>0.05);但上述测定结果均分别与t1和△t之间呈显著相关(P均<0.05)。结论早产儿出生后血清EGF质量浓度呈上升趋势,提示早产儿出生后体内EGF合成和释放增加,可能促进脏器成熟和组织修复。尤其早产儿在出生1周时的血清EGF呈高水平和(或)上升速率较快者,其生后头围的增长速度也较快,提示其今后可能有较好的脑成熟发育水平、较低的精神神经系统后遗症的发生率,以及远期预后良好。
Objective To investigate the relationship between serum levels of epidermal growth factor (EGF) and brain development in preterm infants. Methods From August 2005 to April 2006, 30 newborn wards from Shanghai Children’s Medical Center were randomly divided into newborns ward, born within 24h, gestational age (238 ± 3) days, 30 preterm infants were enrolled in this study. Enzyme-linked immunosorbent assay (ELISA) were used to measure the level of serum EGF (△ t) in the fasting serum EGF within 24h (t0) and the eighth day (t1) after birth. The bedside cranial ultrasound B was performed to exclude intracranial The head circumference was measured at the corrected gestational age of nearly 40 weeks (6 weeks after birth) and 1 month (10 weeks after birth), and NBNA assessment was performed. The rate of head circumference growth and NBNA difference were calculated. Pearson method was used to analyze all the results. Results Serum EGFt0 in 30 preterm infants was (234.71 ± 58.07) pg / mL, t1 was (347.81 ± 87.49) pg / mL and △ t was (12.14 ± 1.85) pg / (mL.d). Pearson correlation analysis showed that the results of 2 NBNA scores and their differences, 6 weeks and 10 weeks after birth, the head circumference growth rate and growth rate, and t0 no significant correlation (P> 0.05); However, the above determination The results were significantly correlated with t1 and △ t (P <0.05). Conclusions The serum EGF concentration in premature infants after birth is on the rise. It suggests that the synthesis and release of EGF in postnatal infants may increase the maturation and tissue repair. Especially in preterm infants at 1 week after birth serum EGF was high and (or) the rate of rise faster, its growth faster after birth, suggesting that the future may have a better level of brain maturity, lower The incidence of neurological sequelae, as well as the long-term prognosis is good.