Turkan PATIROĞLU, Musa KARAKÜKÇÜ, Aylin İNSAL, Yasemin Altuner TORUN, Mehmet Akif ÖZDEMİR

Yenidoğanlarda hipoksik-iskemik ansefalopati evresi ile eritropoietin düzeyleri arasındaki ilişki: Tedavide kullanılabilir mi?

Amaç: Yenidoğan hipoksik iskemik ansefalopatisi ciddi bir hastalığa ve ölüme sebep olmasına rağmen günümüzde etkin bir tedavisi yoktur. Eritropoietin hipoksik iskemik beyin zedelenmesinden sonra işlevsel olarak iyileşme sağladığı gösterilmesine rağmen uygulama zamanı ve uygun doz uygulaması tam olarak ortaya çıkarılamamıştır. Bu çalışmanın amacı asfiktik yenidoğanlarda hipoksinin şiddeti ve serum eritropoietin seviyesini karşılaştırmak ve bu ilişkinin klinik kullanım açısından önemini değerlendirmektir.Gereç ve Yöntem: Eritropoietin düzeylerini doğum sonrası 0, 12, 24, 36, ve 48. saatlerde enzim immün yöntemi ile dört grupta ölçtük. Bu gruplar (1) evre 1 (n=11); (2) evre 2 (n=9); (3) evre 3 hipoksik iskemik ansefalopatisi olan yenidoğanlar (n=8) ve sağlıklı kontrol grubundan (n=10) oluşmakta idi. Bulgular: Kontrol grubunda eritropoietin düzeyinin geometrik ortalaması 5 mU/mL idi. Eritropoietin seviyeleri 0 ve 12 saatte grup 2 ve 3’de kontrol ve grup 1’e göre; 24 ve 36. saatlerde ise grup 3’de diğer gruplara göre istatistiksel olarak anlamlı derecede yüksekti (p=0,01). Kontrol ve hipoksik iskemik ansefalopati gruplarında 48. saatte fark yoktu (p>0,05). Çıkarımlar: Bu sonuçlara göre zamanında doğan yenidoğanlarda rekombinan insan eritropoietin tedavisinin orta derece hipoksik iskemik ansefalopatide 12 saat, ağır olgularda 24 saat sonra kullanılması gerektiğini düşünmekteyiz.

The relationship between grade of hypoxic-ischaemic encephalopathy and erythropoietin levels in the newborn: Can it be used in treatment?

Aim: Neonatal hypoxic-ischemic encephalopathy leads to mortality and severe morbidity, but currently there is no effective treatment. Erythropoietin has been well characterized and shown to improve functional outcomes after hypoxic-ischemic brain injury; however, application time and optimal dosing regimens have not been clarified. The purpose of this study was to compare the severity of hypoxia with serum erythropoietin levels in the asphyctic newborns and evaluate the importance of this relationship in the terms of its clinical use.Material and Method: We studied erythropoietin concentrations measured at 0 h, 12 h, 24 h, 36 h, and 48 h after birth by enzyme immunoassay in four groups: neonates with hypoxic-ischaemic encephalopathy (1) grade 1 (n=11); (2) grade 2 (n=9); (3) grade 3 (n=8) and control group with healthy newborns (n=10). Results: The geometric mean of erythropoietin concentration was 5.0 mU/mL in the control group. Erythropoietin levels were found significantly increased (p=0.01) in the group 2 and 3 with respect to control and group 1 at 0 h and 12 h; and increased in group 3 with respect to all other groups at 24 h and 36 h (p

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