Increased plasma concentrations of activin A predict intraventricular hemorrhage in preterm newborns
Increased plasma concentrations of activin A predict intraventricular hemorrhage in preterm newborns
复制标题
DOI：
10.1373/clinchem.2005.065979
复制
发表时间：
2006-08-01
影响因子：
9.3
通讯作者：
Buonocore, Giuseppe
中科院分区：
文献类型：
--
作者：
Florio, Pasquale;Perrone, Serafina;Buonocore, Giuseppe
背景：脑室内出血（IVH）是早产儿神经功能障碍的主要原因。我们评估使用血浆激活素A浓度预测围产期IVH.Methods的发展：我们测量有核红细胞（NRBC）计数，血浆激活素A，次黄嘌呤（Hyp），黄嘌呤（Xan）在出生后的第一个小时内从53名早产儿的动脉血样本。在出生后48小时进行脑超声检查，并重复在5或6天的时间间隔，直到4 weeks.Results：I级或II IVH检测在生命的第一个10天的53例（21%）。随后发生IVH的早产儿的激活素A、Hyp和Xan浓度以及NRBC计数高于未发生IVH的早产儿（P < 0.0001，Xan除外，P = 0.019）。新生儿激活素A与（P < 0.0001）与Hyp（r = 0.95），Xan（r = 0.90）;与NRBC计数（r = 0.90）在无晚期IVH的新生儿和发生IVH的新生儿中（Hyp，r = 0.89，P = 0.0002; Xan，r = 0.95，P < 0.0001; NRBC计数，r = 0.90，P = 0.0002）。在0.8 μ g/L激活素A的临界值时，灵敏度和特异性分别为100% [11/11; 95%置信区间（0），71%-100%]和93%。（42例中的39例; 05%CI，81%-98%），阳性和阴性预测值分别为79%（95%CI，61%-100%）和0%（95%CI，0%-2%）。ROC曲线下面积为0.98。结论：IVH早产儿出生时激活素A水平升高，可用于早期发现IVH高危新生儿缺氧缺血性脑损伤。(c)2006年美国临床化学协会。
Background: Intraventricular hemorrhage (IVH) is a major cause of neurologic disabilities in preterm newborns. We evaluated the use of plasma activin A concentrations to predict the development of perinatal IVH.Methods: We measured nucleated erythrocyte (NRBC) counts, plasma activin A, hypoxanthine (Hyp), and xanthine (Xan) in arterial blood samples obtained from 53 preterm infants during the first hour after birth. Cerebral ultrasound was performed with in 48 h of birth and repeated at 5- or 6-day intervals until the age of 4 weeks.Results: Grade I or II IVH was detected during the first 10 days of life in 11 of 53 patients (21%). Activin A, Hyp, and Xan concentrations and NRBC counts we higher in preterm newborns who subsequently developed IVH than in those who did not (P < 0.0001, except P = 0.019 for Xan). Neonatal activin A was correlated (P < 0.0001) with Hyp (r = 0.95), Xan (r = 0.90);,and NRBC count (r = 0.90) in newborns without later IVH and in those who developed IVH (Hyp, r = 0.89, P = 0.0002; Xan, r = 0.95, P < 0.0001; NRBC count, r = 0.90, P = 0.0002). At a cutoff of 0.8 mu g/L activin A, the sensitiviity and specificity were 100% [11 of 11; 95% confidence interval (0), 71%-100%] and 93% (39 of 42; 05% CI, 81%-98%), and positive and negative predictive values were 79% (95% CI, 61%100%) and 0% (95% CI, 0%-2%), respectively. The area under the ROC curve was 0.98.Conclusions: Activin A concentrations at birth are increased in preterm newborns who later develop IVH and may be useful for early identification of infants with hypoxic-ischemic brain insults who are at high risk for IVH. (c) 2006 American Association for Clinical Chemistry.