新生儿缺氧缺血性脑病临床分度与血清同型半胱氨酸及叶酸、维生素B12水平变化的临床研究

目的 探讨血清中高同型半胱氨酸（Hcy）及低叶酸、维生素B12水平与新生儿缺氧缺血性脑病（HIE）临床分度的相关性，为HIE患儿的诊疗提供参考。方法 2010年4月—2011年4月天津市儿童医院新生儿内科收治的患有不同程度HIE的新生儿共94例，其中轻度32例、中度40例、重度22例，对照组为同期收治的诊断为新生儿咽下综合征的新生儿20例。比较各组新生儿血清Hcy、叶酸及维生素B12水平。结果4组新生儿血清Hcy、叶酸、维生素B12水平差异均有统计学意义（均P＜0.05）。与对照组相比，HIE新生儿血清Hcy水平随着HIE临床分度加重而逐渐升高（P＜0.05）；患儿血清叶酸和维生素B12浓度均低于对照组，且重度组维生素B12水平低于中度组（P＜0.05）。结论 HIE患儿血清Hcy水平在对其病情严重程度的评估中具有一定参考价值。对HIE患儿及时给予叶酸及维生素B12的补充可能在疾病的治疗过程中发挥积极作用。

Clinical study on changes of homocysteine,folate and vitamin B12 serum levels in neonates with different clinical index of neonatal hypoxic ischemic encephalopathy

Abstract: Objective To determine whether high serum homocysteine (Hcy) and low folate and vitamin B12 levels are correlated with the clinical index of neonatal hypoxic ischemic encephalopathy(HIE). To provide the reference for the diagnosis and treatment of neonatal patients with HIE. Methods Totally 94 cases of neonatal patients with HIE(32 mild，40 moderate, and 22 severe) treated by Tianjin children's hospital from April 2010 to April 2011 were enrolled.The control group is 20 cases of neonatal patients with neonatal swallowing syndrome over the same period.The serum levels of Hcy, folate and vitamin B12 were compared between four groups. Results The serum levels of Hcy, folate and vitamin B12 have statistical differences in four groups (P＜0.05). Compared with the control group, there were higher levels of Hcy and lower levels of folate and vitamin B12 in HIE groups. The Hcy levels in HIE groups increased with the deterioration of HIE. Serum levels of vitamin B12 in severe group are lower than those in the moderate group（P＜0.05）. Condusions The Hcy serum levels of neonatal patients with HIE have certain reference value in the assessment of the severity of HIE. To give timely supplementary folate and vitamin B12 neonatal patients with HIE may play an active role in the process of the treatment.