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首页> 外文期刊>Archives of disease in childhood. Fetal and neonatal edition >Therapeutic hypothermia delays the C-reactive protein response and suppresses white blood cell and platelet count in infants with neonatal encephalopathy
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Therapeutic hypothermia delays the C-reactive protein response and suppresses white blood cell and platelet count in infants with neonatal encephalopathy

机译：低温治疗可延缓新生儿脑病婴儿的C反应蛋白反应并抑制白细胞和血小板计数

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Background Therapeutic hypothermia (HT) delays the cytokine response in infants with neonatal encephalopathy (NE).Objective To determine if HT delayed the C-reactive protein (CRP) response and altered white blood cell (WBC), neutrophil and platelet count course during the first week of life in infants with NE. Design Retrospective cohort study! Setting Regional neonatal intensive care unit, UK. Patients 104 term infants with NE (38 normothermia (NT) and 66 HT) born between 1998 and 2010. Infants not exposed to prenatal sepsis risk factors were classified as group 'A' and exposed infants to group 'B'. CRP >10 mg/Lwas defined as significant response. Main outcome measures Time to CRP >10 mg/L, peak CRP, WBC, neutrophil and platelet count. Results Blood cultures were negative in all the infants. In babies who had CRP response, HT delayed time to CRP >10 mg/L (median (95% Cl): group A, HT: 36 h (28.3 to 48.0); NT: 24 h (0.0 to 24.0); p=0.001; group B, HT: 30 h (15.2 to 56.8); NT: 12 h (0.0 to 24.0); p=0.009) and time to peak CRP (median (95% Cl): group A, HT: 60 h (60.0 to 72.0); NT: 36 h (0.0 to 48.0); p=0.001; group B, HT: 84 h (62.1 to 120.0); NT: 24 h (0.0 to 36.0); p=0.001). Compared with NT, HTwas associated with reduction in slope of CRP elevation by 0.5 (95% Cl 0.04 to 0.97), WBC by 2,18x109/L (95% Cl 0.002 to 4.35) and platelet count by 32.3x109/L (95% Cl 2.75 to 61.8) independent of exposure to sepsis risk, meconium aspiration and severity of asphyxia. Conclusions Therapeutic hypothermia delayed the initiation of CRP and its peak response, and depressed the WBC and platelet count compared with NT.
机译：背景治疗性低温（HT）可以延缓新生儿脑病（NE）婴儿的细胞因子反应。 NE婴儿出生后的第一周。设计回顾性队列研究！在英国设立地区新生儿重症监护室。 1998年至2010年之间出生的104例足月新生儿为NE（38正常体温（NT）和66 HT）婴儿。未暴露于产前败血症危险因素的婴儿分类为'A'组，而暴露于'B'组的婴儿。 CRP> 10 mg / L被定义为显着反应。主要结果指标CRP时间> 10 mg / L，CRP峰值，WBC，中性粒细胞和血小板计数。结果所有婴儿的血培养均为阴性。在具有CRP反应的婴儿中，HT延迟至CRP> 10 mg / L的时间（中位数（95％Cl）：A组，HT：36小时（28.3至48.0）; NT：24小时（0.0至24.0）; p = 0.001; B组，HT：30 h（15.2至56.8）; NT：12 h（0.0至24.0）; p = 0.009）和达到CRP峰值的时间（中位数（95％Cl）：A组，HT：60 h（ 60.0至72.0）; NT：36小时（0.0至48.0）; p = 0.001; B组，HT：84小时（62.1至120.0）; NT：24小时（0.0至36.0）; p = 0.001）。与NT相比，HT使CRP升高的斜率降低了0.5（95％Cl 0.04至0.97），WBC降低了2,18x109 / L（95％Cl 0.002至4.35），血小板计数降低了32.3x109 / L（95％） Cl 2.75至61.8）与败血症风险，胎粪吸入和窒息严重程度无关。结论低温治疗与NT相比延迟了CRP的启动及其峰值响应，降低了WBC和血小板计数。

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