肾上腺髓质素与新生儿缺氧缺血性脑病的关系

The relationship between adrenomedullin and the Newborn with hypoxic-ischemic encephalopathy

目的探讨肾上腺髓质素与新生儿缺氧缺血性脑病的关系。方法以80例足月缺氧缺血性脑病患儿为对象，30例足月正常新生儿为对照，于生后1d内，（10～14）d取外周静脉血，用放射免疫法测定血浆肾上腺髓质素水平。结果（1）缺氧缺血性脑病轻、中、重度组血浆肾上腺髓质素水平较对照组明显升高（P〈O．01）；缺氧缺血性脑病轻度组血浆肾上腺髓质素水平显著低于中、重度组（P〈0．01）；缺氧缺血性脑病中度组血浆肾上腺髓质素水平较重度组明显降低（P〈0．01）；血浆肾上腺髓质素水平随缺氧缺血性脑病患儿病情程度的加重而有增高的趋势；（2）缺氧缺血性脑病中、重度组恢复期血浆肾上腺髓质素水平较急性期下降，差异有显著性（P〈O．05，P〈0．01），而轻度组差异无显著性（P〉0．05）。结论肾上腺髓质素可能对新生儿缺氧缺血性脑病有保护作用；肾上腺髓质素可作为新生儿缺氧缺血性脑病严重程度的标志物。

Objective To study the relationship between adrenomedullin（ADM） and the Newborn with hypoxic-ischemic encephalopathy（HIE）. Methods The concentration of ADM was measured in the HIE group （n = 80） and control group（n = 30） by radioimmunoassay（RIA）. Vein blood samples were obtained on the first day and the 10-14 th day after birth. Results The concentration of ADM was significantly higher in the HIE group than that in the control group（P〈0. 01）. The concentration of ADM increased progressively following HIE becoming heavier in the HIE group（P〈0. 01）. The level of ADM was obviously higher in the acute stage than that in the restoration stage in the moderated and severed HIE group（P〈0. 05, P〈0. 01）; there is no difference between the acute stage and restoration stage in the mild HIE group（P〉0. 05）. Conclusions The ADM may provide the positive effect on the HIE. ADM can be regarded as the marker of severe HIE.