Aslı Okbay Güneş, Aydın Bozkaya, Mehmet Emin Avlanmış
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引用次数: 0
摘要
目的:确定与接受治疗性低温疗法(TH)的缺氧缺血性脑病(HIE)新生儿降钙素原水平相关的因素。研究对象包括接受治疗性低温的中度/重度缺氧缺血性脑病新生儿。新生儿在完成复温后按降钙素原(PCT)水平分为两组。采用单变量和多变量逻辑回归评估与 PCT 水平相关的因素。第一组包括 123 名(87.9%)新生儿,第二组包括 17 名(12.1%)新生儿。中位胎龄为 38(36-39)周,平均出生体重为 3081.7 ± 552.8 克。在第二组中,重度 HIE、剖宫产、抗生素转换、惊厥、肌注和死亡率较高,住院时间较长,而 Apgar 评分较低(P < .05)。研究发现,重度 HIE 患儿出现高降钙素原水平的风险比剖宫产患儿高 6 倍(95% CI 1.9-19.1),高 5.2 倍(95% CI 1.7-16)。在患有 HIE/TH 的新生儿中,升温后降钙素原水平高与重度 HIE 和剖宫产有关。其他一些可能反映临床状况恶化的临床和实验室结果也与降钙素原水平高有关。
Factors Associated with Post-rewarming Procalcitonin Levels in Newborns with Hypoxic Ischemic Encephalopathy.
To determine the factors associated with the procalcitonin levels in newborns with hypoxic-ischemic encephalopathy (HIE) who received therapeutic hypothermia (TH). The neonates, who had moderate/severe HIE and were treated with TH, were included. The neonates were arranged into 2 groups by procalcitonin (PCT) level after rewarming was completed. The neonates who had a procalcitonin level of < 2.5 ng/ml constituted Group 1 and the ones who had a procalcitonin level of ≥ 2.5 ng/ml constituted Group 2. Univariate and multivariate logistic regression was used to assess the factors related with PCT level. The first group included 123 (87.9%) neonates and the second group included 17 (12.1%) neonates. The median gestational age was 38 (36-39) weeks and the mean birth weight was 3081.7 ± 552.8 grams. In group 2, the rates for severe HIE, cesarean section, antibiotic switch, convulsion, inotrope use and mortality were higher, and duration of hospitalization was longer, whereas Apgar scores were lower (P < .05). The risk of a high procalcitonin level was found to be 6-fold (95% CI 1.9-19.1) higher in severe HIE and 5.2-fold higher (95% CI 1.7-16) in cesarean delivery. In neonates with HIE/TH, high post-rewarming procalcitonin levels were related with severe HIE and cesarean delivery. Some other clinical and laboratory findings, which may reflect worse clinical status, were also associated with high procalcitonin levels.