The changes of cerebrospinal fluid non-protein-bound iron and malondialdehyde(MDA) in preterm infants with severe intraventricular hemorrhage (IVH) after serial lumbar punctures

Abstract

Objective To investigate the changes and clinical significance of cerebrospinal fluid (CSF) non-protein-bound iron and malondialdehyde(MDA) in preterm infants with severe intraventricular hemorrhage (IVH) after serial lumbar punctures.Methods Non-protein-bound iron and MDA of CSF in twenty severe IVH preterm infants with first and end lumbar puncture were examined respectively.The control samples were determined for once from first to second week after birth.Results Both Non-protein-bound iron and MDA levels of the first CSF sample in twenty severe IVH preterm infants were higher than that in control[(0.66±0.38)μmol/L vs (0.24±0.12)μmol/L(P<0.01);(1.21±0.41)μmol/L vs (0.89±0.35)μmol/L(P<0.05)].Non-protein-bound iron levels of first and end CSF sample in severe IVH with posthemorrhagic ventricular dilatation (PHVD) were both higher than those without PHVD [(0.75±0.34)μmol/L vs (0.54±0.31)μmol/L;(0.57±0.21)μmol/L vs (0.35±0.18)μmol/L](P<0.05).However,there was no significant difference in MDA levels between both groups.The levels of non-protein-bound iron of end CSF in severe IVH with and without PHVD were significantly lower than those of the first CSF samples (P<0.05),while,there was no significant difference in MDA levels between the end and first CSF samples.Conclusion The non-protein-bound iron and MDA of CSF in severe IVH preterm infants were both significantly increased,non-protein-bound iron and oxygen free radicals may be involved in the preterm brain injury.Serial lumbar punctures can lower the levels of non-protein-bound iron in CSF. Key words: Intraventricular hemorrhage; Posthemorrhagic ventricular dilatation; Non-protein-bound iron; Malondialdehyde; Serial lumbar punctures; Preterm infant