| Background and objectiveWith the continuous improvement of medical level,the survival rate of premature infants has improved significantly.However,the incidence rate of brain injury in preterm infants has also been significantly improved.Among them,the most common type of brain damage in premature infants is White matter damage(WMD).WMD is the major cause of many chronic neurological diseases in preterm infants.It may lead to cerebral palsy,mental retardation,audio-visual disorders,motor retardation,etc.,and increase the burden of family and society.WMD has no specific clinical manifestations in the early stage,so prevention and early intervention of WMD become a new clinical problem.serum ferritin(SF)is the main protein that stores iron in human body.In recent years,the role of brain iron metabolism in the pathogenesis of brain injury has been paid more and more attention.The research shows that iron is involved in the damage process of nervous system diseases such as cerebral hemorrhage,cerebral infarction and hypoxic-ischemic encephalopathy.whether it is involved in the pathogenesis of brain white matter damage in preterm infants,and whether it can be used as an index to measure the degree of WMD,has not been reported in China.The purpose of this paper is to study the changes of serum ferritin(SF)level in premature infants with WMD,to observe the relationship between SF and WMD,to explore the value of SF in the early diagnosis of brain white matter injury in premature infants,and to explore the relationship between the changes of SF level and the severity of the disease.Materials and methodsFrom June 2018 to October 2019,236 premature infants in our hospital within 24 hours of birth were selected for the study,with a gestational age of 28-32 weeks.According to the brain MRI results of premature infants within 2 weeks after birth,100 cases in the control group without brain white matter injury,60 cases in the mild brain white matter injury group,56 cases in the moderate brain white matter injury group and 20 cases in the severe brain white matter injury group were divided into three groups.There was no significant difference in gestational age,sex,birth weight and hemoglobin content among the four groups(P>0.05).Peripheral venous blood was collected from 236 premature infants on the first day and the fourteenth day of admission,and supernatant was collected by centrifugation.Spss21.0 software was used to analyze the data.Results1.The change of SF level on the 1st day after birth in the four groups:the SF level in the group of brain white matter injury was higher than that in the control group,with statistical significance(P<0.05);there was no statistical significance between the mild group and the control group in different clinical graduations(P>0.05),and the ferritin content in the severe group was higher than that in the control group and the mild to moderate group,with statistical significance(P<0.05).2.The change of SF level in the fourth group on the 14th day after birth:there was no significant difference between the group with brain white matter injury and the control group(P>0.05);there was no significant difference in SF content between the control group,mild,moderate and severe brain white matter injury group.3.The changes of SF on the 14th day after birth and on the 1st day after birth in the four groups of premature infants:The SF levels of the preterm infants in the control group and mild group were not significantly changed on the 14th day after birth compared with the 1st day after birth,the difference was not statistically significant P>0.05);SF levels of premature infants in the moderate and severe groups increased significantly on the first day after birth,and fell to normal on the 14th day after birth,the difference was statistically significant(P<0.05).At the same time,the brain MRI showed that the abnormal signal shadow in the white matter area of the mild and moderate brain white matter injury group disappeared completely,and the abnormal signal shadow in the white matter area of the severe brain white matter injury group improved significantly.ConclusionThere was no correlation between mild brain white matter injury and serum ferritin in preterm infants.Serum ferritin in preterm infants with moderate and severe brain white matter injury increased significantly after birth.The increased level can reflect the severity of brain white matter injury,which provides a basis for early diagnosis and intervention of brain white matter injury in moderate and severe preterm infants.on the 14th day,brain MRI showed that mild and moderate brain white matter injury was basically cured.The severe group brain white matter injury was significantly better than before,indicating that after treatment,brain white matter injury was gradually improved,SF was also gradually reduced to normal... |
PDF Full Text Request