脐血促红细胞生成素水平对缺氧缺血性脑损伤的诊断价值:临床观察横断面研究

S. Berezhanskaya, M. К. Abduragimova
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引用次数: 0

摘要

背景近年来,红细胞生成素因其重要的非血液学作用而受到特别关注。促红细胞生成素被认为是一种多能性糖蛋白,表现出嗜神经和神经保护特性,并参与血管、神经和少突胶质细胞的生成,干扰缺氧缺血、氧化应激的影响,并与之相关的大脑炎症和细胞凋亡。在胎儿缺氧期间,红细胞生成素的主要生产转移到胎盘,开始其活性合成,以保护大脑、心脏和其他重要器官免受严重缺氧的有害影响。目标。该研究旨在确定缺氧缺血性脑损伤的严重程度与脐带动脉和静脉中红细胞生成素水平之间的相关性。方法。在妇产医院、新生儿病理学和儿科的基础上进行了一项临床观察横断面研究№1和№俄罗斯联邦罗斯托夫国立医科大学主持的妇产科和儿科研究所2号。该研究包括184名中度(第II组,n=78)和重度缺氧缺血性中枢神经系统损伤的新生儿(第III组,n=42)。第一组包括64名新生儿早期没有中枢神经系统损伤迹象的儿童。其中,根据母体病史,40名新生儿被分配到神经病理学延迟表现明显的组。用促红细胞生成素EIA-BEST(一套酶联测定血清中促红细胞产生素浓度的试剂)分别在动脉和静脉中评估脐带血中的促红细胞形成素浓度。通过MS Excel 2019(Microsoft,USA)、Statistica 12.5(IBM,USA)和SPSS27.001进行统计分析。结果根据缺氧缺血性脑损伤的严重程度测定各组新生儿脐带动脉和静脉血液中的促红细胞生成素浓度。该研究的作者显示了妊娠36-40周时“母体-胎盘-胎儿”血流量(这些参数是中枢神经系统损伤的重要产前预测指标)与动脉和静脉脐带血中红细胞生成素作为诊断标志物的价值之间的相关性。结论大脑异常的严重程度取决于红细胞生成素的高水平,而红细胞生成蛋白水平的降低和严重的大脑缺陷可能标志着致残性损伤。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diagnostic Value of Erythropoietin Levels in Umbilical Cord Blood in Hypoxic-Ischemic Brain Injury: Clinical Observational Cross-Sectional Study
Background. In recent years erythropoietin has received particular attention due to the discovery of its important non-haematological effects. Erythropoietin is recognized as a pluripotent glycoprotein, manifesting neurotropic and neuroprotective properties as well as participating in angio-, neuro- and oligodendrogenesis, interferes with the effects of hypoxia-ischemia, oxidative stress and associated with them inflammation and apoptosis in the brain. During fetal hypoxia, the dominant production of erythropoietin switches to the placenta, starting its active synthesis to protect the brain, heart and other vital organs from harmful effects of severe hypoxia.Objectives. The study was aimed at determining the correlation between the severity of hypoxic ischemic brain injury and erythropoietin level in the artery and vein of the umbilical cord.Methods. A clinical observational cross-sectional study was conducted on the basis of the Maternity Hospital, Neonatal Pathology and Pediatric Departments №1 and №2 of the Research Institute of Obstetrics and Pediatrics under the auspices of Rostov State Medical University, Russian Federation. The study included 184 newborns with moderate (group II, n = 78) and severe hypoxic ischemic injury of the central nervous system (group III, n = 42). Group I consisted of 64 children without signs of central nervous system injury in the early neonatal period. Among which, following the maternal medical histories, 40 newborns were allocated to the group with the apparent development of delayed manifestation of neurological pathology. The evaluation of erythropoietin concentration in the umbilical cord blood was conducted separately in the artery and vein with Erythropoietin-EIA-BEST, a set of reagents for the enzyme-linked determination of erythropoietin concentration in the blood serum. Statistical analysis was carried out via MS Excel 2019 (Microsoft, USA), Statistica 12.5, (IBM, USA), SPSS27.001.Results. Erythropoietin concentrations in the blood of the artery and vein of the umbilical cord in the groups of newborns were determined according to the severity of hypoxic-ischemic brain injury. The authors of the study showed the correlation between the “maternal-placental-fetal” blood flow at 36–40 weeks of gestation, which parameters are important antenatal predictors of the central nervous system injury, and the values of erythropoietin in arterial and venous umbilical cord blood as diagnostic markers.Conclusion. The severity of cerebral abnormalities is determined by a high level of erythropoietin, while a decrease in erythropoietin level with severe cerebral deficit can mark a disabling injury.
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