新生儿缺氧缺血性脑病血浆血管活性因子动态变化的临床研究

Clinical research on changes of plasma ET,CGRP,and ANP in neonates with hypoxic-ischemic encephalopathy

目的探讨新生儿缺氧缺血性脑病(HIE)患儿血浆内皮素(ET)、降钙素基因相关肽(CGRP)及心钠素(ANP)的相互作用及其在HIE发病过程中的作用机制。方法应用放射免疫分析法测定46例HIE患儿和26例正常新生儿的血浆ET、CGRP和ANP的含量。结果HIE组急性期血浆ET、CGRP和ANP水平明显高于对照组及恢复期,差异有非常显著意义(P<0.001);病情越重,ET、CGRP和ANP水平越高;恢复期血浆ET、CGRP和ANP水平逐渐下降,但仍较对照组偏高,尤其中、重度组下降的幅度更为缓慢;HIE组治疗前后血浆ET与CGRP、ET与ANP水平呈直线正相关。结论血浆ET、CGRP和ANP共同参与了HIE发病机制及病理过程,其水平的动态变化有助于病情判断,评估疗效及预后。

Objective To investigate the interaction of plasma endothelin（ET）, calcitonin gene-related peptide（CGRP）, and atrial natriuretic polypeptide （ANP）, search the mechanism of interaction in neonates with hypoxic-ischemic encephalopathy（HIE）. Methods We measured plasma ET, CGRP, and ANP for 46 neonates with HIE and 26 normal newborns by radioimmunoassay. Results Levels of ET, CGRP, and ANP in serum elevated significantly in HIE group, compared with the control group. In HIE group the levels were higher at the acute phase than that at the convalescence phase, the differences were very significant（ P 〈0.001）. The more severe the cases were, the higher the levels of ET, CGRP, ANP in serum were. In HIE group the level of ET, CGRT, ANP in serum decreased gradually at the convalescence phase, but were higher than the control group, especially in the moderate and severe groups. In HIE group there were positive correlations between the level of ET and CGRP, ET and ANP before and after treatment. Conclusion In the patients of neonates with HIE, plasma ET, CGRT, and ANP take part in the pathogenesis and pathologic process, their levels help to judge the state of the illness, evaluate therapeutic effectiveness and prognosis.