目的 探讨血清纤溶酶原激活物对新生儿窒息病情评估的临床意义,为新生儿窒息提供一种客观的临床诊断方法。方法 选取2012年1月—2013年6月于本院新生儿科就诊并住院治疗的足月窒息新生儿64例,根据疾病严重度分为轻度窒息组(n=34)和重度窒息组(n=30),同时选取同期足月健康新生儿20例为对照组。采用酶联免疫吸附试验检测3组血清组织型纤溶酶原激活物(t-PA)、纤溶酶原激活物抑制剂-1(PAI-1)的含量进行比较,并分析t-PA、PAI-1含量与Apgar评分的相关性。结果 3组血清t-PA和PAI-1含量,差异有统计学意义;轻度窒息组血清t-PA和PAI-1含量[(35.8±2.9)ng/ml、(40.2±3.6)ng/ml]高于对照组[(19.2±2.2)ng/ml、(24.1±2.3)ng/ml],重度窒息组患儿血清t-PA和PAI-1含量[(41.4±2.6)ng/ml、(64.2±3.9)ng/ml]高于轻度窒息组和对照组,差异均有统计学意义;血清t-PA、PAI-1含量与患儿Apgar评分负相关(r₁=-0.587;r₂=-0.407)。结论 窒息新生儿的血清t-PA、PAI-1的表达增高,并随着窒息程度的增加,其水平递增。血清t-PA、PAI-1可作为新生儿窒息病情评估的指标,对临床完善新生儿窒息的诊断具有重要意义。

Objective To evaluate the clinical implications of serum plasminogen activator detection for neonatal asphyxia assessment, and to provide a new method for the clinical diagnosis of neonatal asphyxia. Methods Sixty-four cases of full-term neonates with asphyxia were selected in the Neonatology Department of our hospital during January 2012 and June 2013, and 20 cases of healthy full-term newborns were selected as controls over the same period. Serum tissue plasminogen activator (t-PA) and plasminogen activator inhibitor -1 (PAI-1) levels were detected by enzyme-linked immunosorbent assay. Differences in serum t-PA and PAI-1 levels between the neonatal asphyxia and control groups were examined, and correlations between the two markers and Apgar score were analyzed. Results Serum t-PA and PAI-1 levels of the mild asphyxia group, severe asphyxia group, and the control group were statistically significant different. The mild asphyxia group had significantly higher levels of serum t-PA and PAI-1 than the control group, and the severe asphyxia group had higher levels of the two markers than the mild asphyxia group and the control group. Negative correlations between serum t-PA and PAI-1 levels with Apgar score were observed (r₁=-0.587 and r₂=-0.407, respectively). Conclusion Serum t-PA and PAI-1 expression levels may be used as indicators for neonatal asphyxia assessment.