Detection of alpha II-spectrin breakdown products in the serum of neonates with congenital heart disease*.
Detection of alpha II-spectrin breakdown products in the serum of neonates with congenital heart disease*.
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DOI：
10.1097/pcc.0000000000000059
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发表时间：
2014-03
期刊：
影响因子：
--
通讯作者：
Levy RJ
中科院分区：
文献类型：
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作者：
Jain P;Spaeder MC;Donofrio MT;Sinha P;Jonas RA;Levy RJ
确定围手术期先天性心脏病新生儿血清中是否可检测到α II-血影蛋白分解产物。前瞻性观察性队列研究。城市三级医疗学术中心的儿科心脏ICU。患有先天性心脏病的新生儿接受手术修复或姑息治疗。用于测量120和150 kDa血影蛋白分解产物的连续血液采样。对14例接受心脏手术的先天性心脏病新生儿进行了评价。9名婴儿接受了心内直视手术，5名婴儿接受了心内直视手术。术前及术后6、24、48、72和96小时，用夹心酶联免疫吸附试验测定血清血影蛋白分解产物。作为常规临床护理的一部分，在12名患者术前和6名患者术后获得脑成像。6例患者术前影像学检查正常（3例心脏闭合手术和3例心脏直视手术），而6例患者术前有神经损伤证据（1例心脏闭合手术和5例心脏直视手术）。只有1例患者进行了术后影像学检查，没有损伤。所有其他患者均表现为梗死或出血。与术前值和时间匹配的心脏闭合手术水平相比，心脏直视手术后24小时，Spectrin分解产物120 kDa显著增加。与术前值相比，在心脏直视手术后6小时，Spectrin分解产物150 kDa显著增加。心脏手术后血影蛋白分解产物无显著变化。与心脏直视手术相比，心脏直视手术后血影蛋白分解产物峰值显着增加。血影蛋白分解产物可在围手术期先天性心脏病新生儿的血清中检测到，并且在心脏直视手术后的婴儿中水平增加到更大程度。这些研究结果表明，在未来的工作中，血清血影蛋白分解产物可能被开发为先天性心脏病婴儿脑坏死和细胞凋亡的生物标志物。
To determine if alpha II-spectrin breakdown products can be detected in the serum of neonates with congenital heart disease in the perioperative period. Prospective observational cohort study. Pediatric cardiac ICU in an urban tertiary care academic center. Neonates with congenital heart disease undergoing surgical repair or palliation. Serial blood sampling for measurement of 120 and 150 kDa spectrin breakdown products. Fourteen neonates with congenital heart disease undergoing cardiac surgery were evaluated. Nine infants underwent open-heart surgery and five underwent closed-heart surgery. Serum spectrin breakdown products were measured with sandwich enzyme-linked immunosorbent assay preoperatively and then 6, 24, 48, 72, and 96 hours following surgery. Brain imaging was obtained as part of routine clinical care in 12 patients pre-operatively and six patients postoperatively. Six patients had normal preoperative imaging (three closed-heart surgery and three open-heart surgery), whereas six had evidence of neurologic injury prior to surgery (one closed-heart surgery and five open-heart surgery). Only one patient had a postoperative imaging study that lacked injury. All others demonstrated infarction or hemorrhage. Spectrin breakdown product 120 kDa significantly increased 24 hours after open-heart surgery compared to preoperative values and time-matched closed-heart surgery levels. Spectrin breakdown product 150 kDa significantly increased 6 hours after open-heart surgery compared to preoperative values. There was no significant change in spectrin breakdown products following closed-heart surgery. Peak spectrin breakdown products significantly increased following open-heart surgery compared to closed-heart surgery. Spectrin breakdown products can be detected in the serum of neonates with congenital heart disease in the perioperative period and levels increased to a greater degree in infants following open-heart surgery. These findings suggest that, in future work, serum spectrin breakdown products may potentially be developed as biomarkers for brain necrosis and apoptosis in infants with congenital heart disease.