Pediatric Hematology/Oncology and ImmunopathologyPediatric Hematology/Oncology and ImmunopathologyВопросы гематологии/онкологии и иммунопатологии в педиатрии1726-17082414-9314Fund Doctors, Innovations, Science for Children73910.24287/1726-1708-2023-22-3-136-145ORIGINAL ARTICLESОРИГИНАЛЬНЫЕ СТАТЬИUnknownDiagnostic significance of serum erythropoietin as a marker of perinatal brain damage in premature newborns with very low birth weightДиагностическая значимость сывороточного эритропоэтина как маркера перинатального поражения головного мозга у недоношенных новорожденных с очень низкой массой тела при рожденииhttps://orcid.org/0000-0001-9626-5481SharafutdinovaD. R.ШарафутдиноваД. Р.
Russian Federation

Diiana R. Sharafutdinova - Cand. Med. Sci., a senior researcher, an anesthesiologist-intensivist at the A.G. Antonov ICU of assistant of the Department of Continuing Professional Education and Simulation Technologies, NMRCOGP named after the Academician V.I. Kulakov; Associate Professor at the Department of Neonatology of the N.F. Filatov Clinical Institute for Children's Health, the I.M. Sechenov First MSMU.

2, building 4 Bolshaya Pirogovskaya St., Moscow 119435

Шарафутдинова Дияна Рашидовна - кандидат медицинских наук, старший научный сотрудник, врач-анестезиологреаниматолог отделения реанимации и интенсивной терапии им. проф. А.Г. Антонова Института неонатологии и педиатрии; ассистент кафедры непрерывного профессионального образования и симуляционных технологий ФГБУ «НМИЦ АГП им. В.И. Кулакова» Минздрава России; доцент кафедры неонатологии Клинического института детского здоровья им. Н.Ф. Филатова Первый МГМУ им. И.М. Сеченова.

119435, Москва, ул. Большая Пироговская, 2, стр. 4

dikarush@gmail.comBalashovaE. N.БалашоваЕ. Н.
Russian Federation

Moscow

Москва

dikarush@gmail.comKesslerYu. V.КесслерЮ. В.
Russian Federation

Moscow

Москва

dikarush@gmail.comhttps://orcid.org/0000-0002-0591-4325VedikhinaI. A.ВедихинаИ. А.
Russian Federation

Moscow

Москва

dikarush@gmail.comhttps://orcid.org/0000-0001-9657-5375SukhovaYu. V.СуховаЮ. В.
Russian Federation

Moscow

Москва

dikarush@gmail.comhttps://orcid.org/0000-0002-7628-8157KirtbayaА. R.КиртбаяА. Р.
Russian Federation

Moscow

Москва

dikarush@gmail.comhttps://orcid.org/0000-0001-5560-8759RyndinA. Yu.РындинА. Ю.
Russian Federation

Moscow

Москва

dikarush@gmail.comhttps://orcid.org/0000-0002-7990-0276IvanetsT. Yu.ИванецТ. Ю.
Russian Federation

Moscow

Москва

dikarush@gmail.comhttps://orcid.org/0000-0002-4153-133XIonovO. V.ИоновО. В.
Russian Federation

National Medical Research Center for Obstetrics, Gynecology and Perinatology named after the Academician V.I. Kulakov of Ministry of Healthcare of the Russian Federation

Москва

dikarush@gmail.comNational Medical Research Center for Obstetrics, Gynecology and Perinatology named after the Academician V.I. Kulakov of Ministry of Healthcare of the Russian FederationФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии им. акад. В.И. Кулакова» Минздрава РоссииI.M. Sechenov First Moscow State Medical University of Ministry of Healthcare of the Russian Federation (Sechenov University)ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)I.M. Sechenov First Moscow State Medical University of Ministry of Healthcare of the Russian Federation (Sechenov University)ФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии им. акад. В.И. Кулакова» Минздрава РоссииNational Medical Research Center for Obstetrics, Gynecology and Perinatology named after the Academician V.I. Kulakov of Ministry of Healthcare of the Russian FederationФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)I.M. Sechenov First Moscow State Medical University of Ministry of Healthcare of the Russian Federation (Sechenov University)ГБУЗ МО «Научно-исследовательский клинический институт детства Министерства здравоохранения Московской области»Research Clinical Institute of Childhood of the Ministry of Health of the Moscow Region031020232231361451606202303072023Copyright ©; 2023, «D. Rogachev NMRCPHOI»Copyright ©; 2023, ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава России2023«D. Rogachev NMRCPHOI»ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава Россииhttps://creativecommons.org/licenses/by/4.0https://hemoncim.com/jour/article/view/739

The search for promising markers of brain damage in premature newborns is important for the development and optimization of individual diagnostic and therapeutic approaches to neuroprotection in neonatology. Objective: to evaluate the diagnostic significance of serum erythropoietin (sEPO) on the 1st day of life as a marker of perinatal brain damage in premature infants with very low birth weight (VLBW). The study protocol was approved by the Biomedical Research Ethics Committee (Minutes No.12 of 17 November 2016) and the Scientific Council (Minutes No.19 of 29 November 2016) of the National Medical Research Center for Obstetrics, Gynecology and Perinatology named after the Academician V.I. Kulakov of Ministry of Healthcare of the Russian Federation. Written informed consent to the patients' participation in the study was obtained from their parents. The study included 47 premature infants with VLBW born in 2018 at the National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov of the Ministry of Healthcare of the Russian Federation. In these patients, sEPO was determined on the 1st day of life. Depending on the level of sEPO, infants were divided into 3 groups: group 1 – premature infants with VLBW with a low sEPO level on the 1st day of life (< 20 IU/L, n = 24); group 2 – premature infants with VLBW with an average sEPO level of 20–39 IU/L (reference values) (n = 14) – control group; group 3 – premature infants with VLBW with an elevated sEPO level (≥ 40 IU/L, n = 9). We determined the frequency of brain damage, including intraventricular hemorrhages (IVH) and periventricular leukomalacia. sEPO was not correlated with gestational age. In group 1, IVH ≤ Grade II was observed in 4/24 (16.7%) infants; in group 2, IVH ≤ Grade II was observed in 3/14 (21.4%) infants, and 1/14 (7.1%) infant had IVH Grade III; in group 3, IVH ≤ Grade II was noted in 1/9 (11.1%) infant, and IVH Grade III – in 1/9 (11.1%) infant, p > 0.05. There were no cases of periventricular leukomalacia. A high sEPO level on the 1st day of life in premature infants with VLBW was not associated with an increased risk of perinatal brain damage. The clinical value and practical significance of the determination of sEPO on the 1st day of life as a marker of perinatal brain damage in premature infants with VLBW did not demonstrate any benefits. Further studies are required to assess the role of sEPO in predicting neonatal outcomes.

Поиск перспективных маркеров повреждения головного мозга у недоношенных новорожденных представляет большой интерес и имеет важное значение для разработки и оптимизации индивидуальных диагностических и терапевтических подходов нейропротекции в неонатологии. Цель: оценить диагностическую значимость сывороточного эритропоэтина (сЭПО) в 1-е сутки жизни (с. ж.) как маркера перинатального поражения головного мозга у недоношенных новорожденных c очень низкой массой тела (ОНМТ) при рождении. Исследование одобрено комиссией по этике биомедицинских исследований (протокол №12 от 17 ноября 2016 г.) и утверждено решением ученого совета (протокол №19 от 29 ноября 2016 г.) ФГБУ «НМИЦ АГП им. акад. В.И. Кулакова» Минздрава России. От родителей пациентов было получено письменное информированное согласие на включение в исследование. В исследование были включены 47 недоношенных новорожденных с ОНМТ, родившихся в 2018 г. в ФГБУ «НМИЦ АГП им. акад. В.И. Кулакова» Минздрава России, у которых в 1-е с. ж. определялась концентрация сЭПО в венозной крови. В зависимости от уровня сЭПО новорожденные были разделены на 3 группы: 1-я группа – недоношенные новорожденные с ОНМТ с низкой концентрацией сЭПО в 1-е с. ж. (< 20 МЕ/л, n = 24); 2-я группа – недоношенные новорожденные с ОНМТ со средней концентрацией сЭПО (20–39 МЕ/л, n = 14) (референтные значения) – группа сравнения; 3 группа – недоношенные новорожденные с ОНМТ с повышенной концентрацией сЭПО (≥ 40 МЕ/л, n  = 9). Мы определяли частоту поражения головного мозга, включая внутрижелудочковые кровоизлияния (ВЖК) и перивентрикулярную лейкомаляцию. В исследуемой когорте концентрация сЭПО не коррелировала с гестационным возрастом. В 1-й группе ВЖК ≤ II степени отмечались у 4/24 (16,7%) новорожденных, во 2-й группе ВЖК ≤ II степени – у 3/14 (21,4%), ВЖК III степени – у 1/14 (7,1%), в 3-й группе ВЖК ≤ II степени – у 1/9 (11,1%), ВЖК III степени – у 1/9 (11,1%), р > 0,05. Случаев перивентрикулярной лейкомаляции среди исследуемых новорожденных не отмечалось. Высокая концентрация сЭПО в 1-е с. ж. у недоношенных новорожденных с ОНМТ не была связана с повышением риска перинатального поражения головного мозга. Клиническая ценность и практическая значимость определения сЭПО в 1-е с. ж. как маркера перинатального поражения головного мозга у недоношенных новорожденных с ОНМТ не продемонстрировали высокой информативности. Для оценки роли сЭПО в прогнозировании неонатальных исходов требуются дальнейшие исследования.

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