新生儿缺氧缺血性脑病时血浆肾素、血管紧张素Ⅱ、醛固酮的变化

Change of plasma renin, angiotensin I and aldosterone and clinical significance in neonates with hypoxic-ischemic en- cephalopathy

采用放射免疫法测定40例新生儿缺氧缺血性脑病(HIE)患儿的血浆肾素(PRA)、血管紧张素Ⅱ(PAⅡ)、醛固酮(PALD)水平。结果显示:PRA无明显变化,急性期轻度HIE的PAⅡ(201.34±51.38Pg/ml)、PALD(0.362±0.107)与中重度HIE的PAⅡ(362.34±75.15Pg/ml)、PALD(0.543±0.152ng/ml)比较,均有显著差异(t=2.813,P<0.05;t=3.101,P<0.05),并且PAⅡ,PALD均与1分钟Apgar评分呈显著负相关(r=0.554,P<0.05;r=-0.561,P<0.05)提示HIE时肾素-血管紧张素-醛固酮系统参与并加重了该病的发生。恢复期HIE的PAⅡ、PALD与正常对照组比较无显著差异(t=0.584,P>0.05;t=0.312,P>0.05),故可用来作病情恢复的指标之一。

Plasma renin (PRA) , Angiotensin Ⅱ (PA Ⅱ )and Aldosterone(PALD)were determined by radioimmunoassay in 40 neonates with hypoxic-ischemic encephalopathy(HIE). The results showed that except for PRA, significant differences of PA Ⅱ (201. 34±51. 38pg/ml vs. 362. 34±75. 15pg/ml,t = 2. 813,P<0. 05)and PALD levels (0. 362±0.107pg/ml vs. 0. 543 ±0. 152pg/ml. t=3. 101 ,P<0. 05)in the acute period were observed between mild HIE group and severe HIE group( and PA Ⅱ and PALD levels were also negatively correlated to Apgar score at 1 minute(r = -0. 554,P<0. 05(r = -0. 561,P<0. 05). No significantly differences of PA Ⅱ and PALD were noticed in the recovery phase comparing to normal controlled group. It is suggested that renin-angiotensin-aldosterone system probably play an important role in the occurrence and development of HIE. It will be valuable to predict the prognosis of HIE as an indicator.