中国实用儿科杂志

中国实用儿科杂志

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窒息新生儿抗凝血酶Ⅲ血管性假血友病因子及D二聚体测定及其临床意义

李志光，冯战桂，文飞球，徐勇   

  1. 暨南大学第二临床学院，深圳市人民医院新生儿科，广东深圳 518020
  • 收稿日期:2005-10-17 修回日期:2005-12-21 出版日期:2005-03-06 发布日期:2005-03-06

A study on antithrombin III,VWF and Ddimer in plasma of asphyxial newborns.

Li Zhiguang,Feng Zhangui Wen Feiqiu,et al.   

  1. Department of Pediatrics,Second Clinical College of Medicine,Jinan University,Shenzhen 518020,China
  • Received:2005-10-17 Revised:2005-12-21 Online:2005-03-06 Published:2005-03-06

摘要： 目的探讨窒息新生儿血浆中抗凝血酶Ⅲ(ATⅢ)、血管性假血友病因子(VWF)、D二聚体(DD)的变化及其意义。 方法深圳市人民医院于2002~2004年，采用酶联荧光分析法和发色底物法分别测定39例不同程度窒息新生儿和16名正常新生儿VWF、DD的水平及ATⅢ的活性，同时检测血小板计数(BPC)、凝血酶原时间(PT)、纤维蛋白原(Fbg)的变化。 结果重度窒息组的ATⅢ明显降低；窒息新生儿血浆的VWF、DD平均值均有不同程度增高，重度窒息组升高更为显著，与正常对照组比较，其差异具有显著性意义(P<0.05，P<0.01)。窒息后并发器官功能损害新生儿较无并发症组血浆的VWF、DD均有不同程度的升高，以颅内出血患儿升高最为明显(P<0.05，P<0.01)。 结论窒息新生儿表现以高凝状态为主的早期DIC、VWF及DD的升高与窒息的程度有关，VWF及DD明显升高者常合并组织器官损害。测定窒息新生儿血浆中ATⅢ、VWF、DD等指标对窒息后新生儿临床选用抗凝药物治疗及疗效观察、预后判断,均有一定的指导意义。

关键词: 窒息, 新生儿, 抗凝血酶Ⅲ, 血管性假血友病因子, D二聚体

Abstract: AbstractObjectiveTo observe the changes of antithrombin III,VWF and Ddimer in asphyxial newborns and study their clinical significane. MethodsFrom 2002 to 2004 ELISA was used to detect ATIII,VWF and Ddimer in 39 cases of asphyxic newborns and 16 normal newborns in Shenzhen People's Hospital. ResultsAntithrombin III in the newborns with severe asphyxia decreased significantly.VWF and Ddimer in the asphyxic newborns were higher than those in the normal controls,especially for the severe asphyxia (P<0.05，P<0.01).VWF and Ddimer in the asphyxial newborns complicated with intracranial hemorrhage were higher than those with other complications or without complications(P<0.05；P<0.01). ConclusionMeasurement of antithrombin III,VWF and Ddimer are useful in evaluating the severity,therapy and prognosis for asphyxic newborns.

Key words: Antithrombin III, VWF, Ddimer , Newborns