窒息新生儿血清同型半胱氨酸与叶酸的变化

目的：探讨血清中高同型半胱氨酸（Hcy）血症及低叶酸水平与新生儿窒息的发生是否具有相关性，并对性别、胎龄等因素对血清中同型半胱氨酸及叶酸水平是否有一定影响进行分析。方法：应用酶联免疫吸附实验方法检测血清中Hcy水平，应用放射免疫法测定血中叶酸浓度。结果：①与无窒息对照组相比, 新生儿窒息患儿血清Hcy水平显著升高，而叶酸水平显著降低；②窒息组男婴血清Hcy、叶酸水平分别为15.82 ±2.51 μmol/L； 2.49 ±0.19 ng/mL，女婴为10.50±2.19 μmol/L; 2.38±0.40 ng/mL,男、女婴之间比较差异无显著性；③窒息组足月儿血清Hcy、叶酸水平为12.34 ±2. 01 μmol/L，2.58 ±0.19 ng/mL；早产儿为21.25±5.01 μmol/L; 2.14±0.34 ng/mL。早产儿Hcy水平显著高于足月儿（P<0.05）。结论：①新生儿窒息与血清Hcy及叶酸水平具有显著相关性。②血清Hcy及叶酸水平在性别上无显著差异。③缺氧窒息合并早产者血清Hcy水平升高最为显著。

Serum levels of homocysteine and folate in neonates with asphyxia

OBJECTIVE: To determine whether serum homocysteine and folate levels are correlated with the occurrence of neonatal asphyxia and to study the effects of gender and gestational age on serum homocysteine and folate levels. METHODS: Thirty-five neonates with mild asphyxia (19 males and 16 females) and 40 normal neonates (control group,18 males and 22 females) were enrolled in this study. The asphyxia and the control groups consisted of 10 and 11 cases of preterm infants respectively. Serum homocysteine levels were measured using ELASA. Serum folate levels were measured using radioimmunity assay. RESULTS: Serum homocysteine level (14.66+/-2.61 micromol/L vs 7.55+/-0.50 mumol/L; P<0.05) was significantly higher and serum folate level (2.47+/-0.24 ng/mL vs 3.28+/-0.28 ng/mL; P<0.05) was significantly lower in the asphyxia group than that in the control group. There were no significant differences in serum levels of homocysteine and folate between males and females either in the asphyxia group or the control group. The asphyxiated neonates born at premature showed increased serum homocysteine level compared with the full-term neonates with asphyxia (21.25+/-5.01 micromol/L vs 12.34+/-2. 01 micromol/L; P<0.05). CONCLUSIONS: The increased serum homocysteine level and decreased serum folate level are correlated with the occurrence of neonatal asphyxia. Serum homocysteine and folate levels are not associated with the gender. A more significantly increased serum homocysteine level may be found in asphyxiated neonates born at premature.