新生儿缺氧缺血性脑病血浆肾上腺髓质素水平及其临床意义

Clinical effect and changes in plasma adrenomedullin in neonate hypoxic-ischemic encephalopathy

目的探讨新生儿缺氧缺血性脑病(HIE)血浆肾上腺髓质素(ADM)水平的变化及临床意义。方法应用放射免疫法对60例HIE患儿和28例正常足月新生儿的血浆ADM水平进行动态观察。结果HIE患儿急性期血浆ADM水平较恢复期及正常对照组显著升高(P均<0.05);HIE恢复期与对照组无显著性差异(P>0.05);急性期重度HIE组明显高于对照组、轻度组及中度组,差异有显著性(P均<0.05);轻、中度HIE组与对照组无显著性差异(P均>0.05)。结论ADM参与了新生儿HIE的发病过程;ADM可作为重度HIE的早期标志物;ADM在HIE中可能具有一定的神经保护作用。

Objective To investigate the changes of the plasma adrenomedulin （ADM） and their chinical implication in neonates with hypoxic-ischemic encephalopathy （HIE）. Methods Dynamic changes of plasma ADM levels were measured in 60 neonates with HIE and 28 normal full term infants by radioimmunoassay. Results Plasma ADM levels in acute period of HIE increased significantly than that in restorative period （P 〈 0.05）, and was significantly higher than that in control group （P 〈 0.05）. There was no significant difference between control group and HIE group in restorative stage （P 〉 0.05）. In acute period plasma ADM level was dramatically higher in severe HIE than that in mild, moderate and control group （P 〈 0.05）. There were no significant difference in mild, moderate HIE and cotrol group （ P 〉 0.05 ）. Conclusion ADM might participate in pathogenesis of neonatal hypoxic-ischemic encephalopathy. ADM can be regarded as a early marker of severe HIE;ADM may play protective effect in the process of HIE.