不同胎龄新生儿血清血管内皮生长因子水平变化及与早产儿视网膜病变的关系

目的 测定不同胎龄新生儿和早产儿视网膜病变(ROP)患儿血管内皮生长因子(VEGF)血清水平变化,并探讨其与ROP的关系.方法 复旦大学附属儿科医院新生儿科入院新生儿184例,根据胎龄分为3组:<32周早产儿组、32～36周早产儿组、足月儿组,各组根据是否吸氧再分为未吸氧和吸氧2个亚组;ROP组为出生体重<2 kg,且在眼科筛查中确诊为ROP的早产儿.各组新生儿分别在生后第1、3、5、7周用酶联免疫吸附法检测血清VEGF水平.结果 未吸氧早产儿组血清VEGF水平随着日龄增加而下降,足月组血清VEGF水平较平稳.32～36周早产儿组血清VEGF水平(ng/L)在第1、3周显著高于足月儿组,差异有统计学意义(522±224比247±123,P=0.000;393±220比247±177,P=0.022).<32周早产儿组血清VEGF水平在第1周稍高于早产儿组,差异无统计学意义(P=0.071).32～36周早产儿组中,吸氧和未吸氧亚组血清VEGF水平(ng/L)差异有统计学意义(第1周:324±148比522±224,P=0.000;第3周:264 ±106比393±220,P=0.005).ROP组血清VEGF水平在第5周反常性升高,与<32周早产儿组相比,差异无统计学意义.ROP组血清VEGF水平(ng/L)在纠正胎龄31周高于非ROP早产儿组,差异有统计学意义(515±154比347±161,P=0.047).结论 早产儿血清VEGF水平异常增高时,可能与ROP的发生有关.动态监测早产儿血清VEGF水平可能有助于预测ROP的发生.

Changes of serum vascular endothelial growth factor in newborn infants and its relationship with retinopathy of prematurity

Objective To observe the changes of serum vascular endothelial growth factor (VEGF)in newborns at different gestational ages and infants with retinopathy of prematurity (ROP) and explore the relationship with ROP.Methods A total of 184 newborns admitted into our hospital were enrolled.They were divided into three groups as < 32 weeks, 32-36 weeks and term neonates based on gestational age.Each group was further divided into two subgroups of non-oxygen and oxygen.The ROP group was diagnosed by ophthalmologist in infants whose birth weights were less than 2000 grams.Serum VEGF was measured by ELISA every other week from birth until discharge.Results In three non-oxygen subgroups, the serum VEGF was declining with postnatal age in prematurities and stable in term neonates.Serum VEGF (ng/L)in 32 - 36 week premature group was much higher than those of term group at Weeks 1 and 3 (522 ± 224 vs247 ± 123, P = 0.000; 393 ± 220 vs 247 ± 177, P = 0.022) ; Serum VEGF in < 32 week premature group was slightly higher than that of term group at Week 1 (P = 0.071 ).Serum VEGF (ng/L) in oxygen subgroup at Weeks 1 and 3 was significantly lower than that of non-oxygen subgroup (324 ± 148 vs 522 ±224, P = 0.000; 264 ± 106 vs 393 ± 220, P = 0.005 ) only in 32 - 36 week premature group.Serum VEGF (ng/L) in ROP group abnormally increased at Week 5 and it was significantly higher than that of prematurities without ROP at 31 weeks of corrected gestational age (515 ± 154 vs 347 ± 161, P =0.047).Conclusions Abnormally elevated serum VEGF in prematurities may be related to ROP.Monitoring serum VEGF in prematurities could help to predict ROP.