الفهرس 
Protein zOnly 14 pages are availabe for public view
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Abstract
Protein Z (PZ) is a single chain, vitamin K- dependent glycoprotein
that was purified from human plasma in 1984 ,analogous with the majority
of the coagulation proteins, protein Z is synthesized in the liver.
It is 62 kDa large and 396 amino acids long. The PROZ gene has
been linked to the thirteenth chromosome (13q34).
The physiological function of protein Z is still rather ill defined. As
is the case with other coagulation proteins and inhibitors, protein Z is
consumed during disseminated intravascular coagulation (DIC) .
It was found an association between low protein Z levels and first
unexplained early fetal loss, Paidas and researcher found significantly
lower first-trimester protein Z levels in a group of patients with
complicated pregnancy outcomes such as bleeding, preeclampsia, preterm
delivery, premature rupture of membranes and intrauterine growth
restriction, as compared to women with normal pregnancy outcomes.
In this study we described the incidence of protein Z deficiency in
neonates with RDS, SGA and Infant of pre-eclampsic mother and there’s
significant decrease in protein z levels in patient group than control group.
This study was conducted on 85 neonate admitted to the pediatric
Department of Menofia University neonatal intensive care unit from
January 2013 to 30 July 2013.
On the day of birth, all information on gestational age, based on last
menstrual period and Dubovitz assessment, head circumference, weight,
Apgar score at 1 and 5 min, clinical data and medications was recorded.
Additional information was collected on maternal history, maternal
diseases, medications and mode of delivery.
Inclusion criteria:- Healthy term and preterm newborns
normal for gestational age (NGA) and newborns belonging to one of the
following groups: newborns small for gestational age (SGA); newborns
affected by RDS, diagnosed on lung X-ray findings, together with the
beginning of respiratory symptoms and the need for any type of ventilatory
support; and newborns from mothers affected by pre-eclampsia.
Exclusion criteria. Newborns with sepsis, congenital malformations
or hemorrhagic disorders.
Newborns were divided into the following groups :
Group I, newborns affected by RDS 20 (10 males and10 females).
Group II, newborns from mothers affected by pre-eclampsia 18 (10
males and 8 females).
Group III, newborns small for gestational age (SGA) 17 (9 males
and 8 females).
(group IV) Healthy term and preterm neonate 30 (13 males and
17 females).
Investigations:- Chest X-ray when indicted, Complete blood count
(C.B.C), C-reactive protein (C.R.B) to exclude sepsis, Arterial blood gases
(A.B.G) when 1ndicated, Prothrombin time , partial thromboplastin time
(PT , PTT) and Protein Z by Immunoenzymatic method (ELISA).
from this study :-
There was no statistical significant difference between group I, II ,
III& IV as regard head circumference, post natal ag, andsex where p value
was >0.05. `
There was statistical significant difference between group I , III& IV
as regard weight where p value was <0.05.There was no statistical significant difference between group I, II ,
III& IV as regard maturity and mode of delivery where p value was >0.05.
There was statistical significant difference between group I & IV as regard
gestational age where p value was <0.05.
There was statistical significant difference between group I, II , III&
IV as regard apgar score where p value was <0.05. `
There was statistical significant difference between group I, II , III&
IV as regard Protein Z: where p value was <0.05. `
There was no statistical significant difference between group II , III&
IV as regard chest examination where p value was >0.05. `
In conclusion, in newborns affected by severe RDS, in newborns born
to pre-eclamptic mothers and in SGA newborns there is a PZ deficiency
which is probably related to activated coagulation in the first two
conditions and to a reduced synthesis in the last one.