RESUMO
Capillary leak syndrome(CLS)is a group of clinical syndromes which caused by various causes of capillary endothelial damage, increased vascular permeability, resulting in a large amount of plasma protein infiltration into the interstitial space.It is one of the common critical cases in Neonatal Intensive Care Unit.As the complicated pathogenesis, blurred clinical stage and often neglected due to other complications, clinical treatment of CLS is difficult.Currently, there is no uniform diagnostic criteria, and the diagnosis is mainly based on clinical manifestation and laboratory examination.The treatment of it is empiric but no specific treatment.Primary disease treatment and fluid management are the critical parts of the treatment of CLS.Now, the etiology, pathogenesis, clinical diagnosis and treatment of the disease were explained combined with the domestic and foreign literature and clinical diagnosis and treatment practices, which aims to improve clinicians′ understanding of the disease and the level of clinical diagnosis and treatment.
RESUMO
Capillary leak syndrome( CLS)is a group of clinical syndromes which caused by various causes of capillary endothelial damage,increased vascular permeability,resulting in a large amount of plasma protein infiltration into the interstitial space. It is one of the common critical cases in Neonatal Intensive Care Unit. As the complicated pathogenesis,blurred clinical stage and often neglected due to other complications,clinical treatment of CLS is difficult. Currently,there is no uniform diagnostic criteria,and the diagnosis is mainly based on clinical manifestation and labora-tory examination. The treatment of it is empiric but no specific treatment. Primary disease treatment and fluid manage-ment are the critical parts of the treatment of CLS. Now,the etiology,pathogenesis,clinical diagnosis and treatment of the disease were explained combined with the domestic and foreign literature and clinical diagnosis and treatment prac-tices,which aims to improve clinicians′understanding of the disease and the level of clinical diagnosis and treatment.
RESUMO
Objective SGA and IURG fetuses are important risk factors for metabolic disease in adulthood,but the mechanism is not clear.In this study,Irisin levels in umbilical cord blood of different birth weight and IURG neonates were measured and the relationship between Irisin and neonatal weight,gestational age and other factors was explored.Methods This study was conducted in the cross-sectional study of neonates born in our hospital from 2014 to 2016.Newborns were divided into small-for-gestational age (SGA),greater-than-gestational age (LGA),gestational age (AGA) and newborns with intrauterine growth restriction (IUGR).The levels of irisin in umbilical cord blood of 4 newborns were detected.Results In this study,there were a total of 110 cases of newborns.The mean gestational age and mean birth weight of newborns in the SGA group was lower than that in the other three groups(P =0.000).The mean Irisin levels in the SGA and IUGR groups [54.4(45.6-66.7) ng/ml,53.7 (40.3-62.4) ng/ml] were significantly lower than those in the AGA group [67.7 (53.8-78.1) ng/ml,64.7 (53.6-71.2) ng/ml] (P =0.000).The mean insulin levels in the LGA group [7.54(0.83-58.96)mIU/ml] were significantly higher than those in the AGA group [38.00(34.40-39.30)mIU/ml] and IU-GR [3.86(0.49-16.15)] and SGA [4.19 (0.62-14.42)mIU/ml] (P =0.000).In the present study,the correlation analysis showed that Irisin level in neonatal umbilical cord blood was significantly correlated with neonatal gestational age (r =0.22,P ＜ 0.01),fetal weight (r =0.17,P ＜0.01) and maternal age (r =-0.12,P =0.021).However,only in the LGA group,the level of Irisin in cord blood of neonates was positively correlated with insulin level (r =0.41,P =0.042).Multivariate linear regression analysis revealed that SGA (β =-0.14,P =0.02) and fetal weight (β =0.05,P =0.008) were independent risk factors for neonatal umbilical cord blood Irisin levels.Conclusion There was a positive correlation between irisin level and neonatal umbilical cord blood birth weight.The levels of irisin in the neonates of the SGA and IURG groups were significantly lower than those of the AGA and LGA groups,but irisin levels did not differ between the SGA and IURG groups and between AGA and LGA groups.And irisin levels in the LGA group were positively correlated with insulin levels.Our results also reveal that singleton infants of mothers with preeclampsia had lower cord blood irisin levels compared to infants of mothers without preeclampsia.