窒息新生儿肾主动脉血流动力学改变与尿液中内皮素变化的关系研究

EXPERIMENTAL STUDY OF RELATIONSHIP BETWEEN HEMODYNAMIC CHANGES OF RENAL MAIN ARTERY AND URINARY ET-1 IN NEONATES WITH ASPHYXIA

目的 :探讨窒息新生儿肾主动脉血流动力学改变及与尿液中内皮素改变的关系 ;方法 :采用高频彩色多普勒超声技术监测窒息新生儿生后 2 4小时内肾主动脉的血流动力学参数 (收缩期峰值流速、舒张末期流速、阻力指数 )变化 ,同时采用放射免疫分析法 (RIA)检测尿液中内皮素 1(ET 1)水平。结果 :与对照组相比 ,窒息组肾主动脉阻力指数增大 ,而收缩期峰值流速和舒张末期流速降低 (P <0 .0 5 ) ,同时尿液中ET 1水平显著增加 (P <0 .0 5 ) ,且ET 1水平与阻力指数大小呈显著正相关关系 ,与舒张末期流速呈显著负相关关系 (r分别为 0 .86和- 0 .72 ,P <0 .0 5 )。结论 :窒息新生儿存在肾主动脉血流动力学改变 ,表现为肾血流灌注不良 ,这可能与ET - 1产生增多有关。

Objective: To study the relationship between the hemodynamic changes of renal main artery and urinary ET?1 in neonates with asphyxia. Methods: CDI technique was used to observe the changes of hemodynamic parameters (PSFV EDFV. RI) of renal main artery during 24h after birth in newborn with asphyxia. At the same time, the ET?1 level in urine was detected by RIA. Results: Compared with the control, the RI of the renal main artery was significantly increased in the asphyxia group, and the Ps and Ed were obviously decreased (P<0.05). The level of ET?1 was increased remarkably (P<0.05) and ET?1 level tended to increase with the RI remarkably, but to decrease with the Ed remarkably (R=0.86 and -0.72 respectively, P<0.05). Conclusion: There were hemodynamic changes of the renal main artery in newborn with asphyxia, which manifested insufficiency in the renal blood perfusion, which may be related to the increase of ET?1.