窒息复苏新生儿红细胞胞浆钙系统的变化规律及其意义

Changes in erythrocyte cytoplasmic calcium system in the newborn infants with hypoxia-ischemia encephalopathy after resuscitation from asphyxia

目的 :探讨窒息复苏新生儿红细胞胞浆钙系统的变化及规律。方法 :使用原子吸收分光光度仪 ,荧光分光光度仪以及钠、钙泵同步测定法检测 2 6例重度窒息缺氧缺血性脑病 (HIE)新生儿及 16例足月正常新生儿红细胞胞浆总钙、游离钙、钙泵、钠泵含量及活性变化。结果 :HIE早期患儿红细胞胞浆总钙〔(3.79± 0 .14)×10 - 3 m mol/ L〕、游离钙含量〔(3.0 4± 0 .5 2 )× 10 - 3 g/ L〕均明显升高 (P<0 .0 5或 P<0 .0 0 1) ;钙泵活性〔(17.6 7± 9.6 9) pmol· g- 1 Hb· h- 1〕、钠泵活性〔(5 .99± 4.31) pmol· g- 1 Hb· h- 1〕均显著降低 (P均 <0 .0 0 1)。结论 :窒息缺氧缺血性脑病过程伴发红细胞内钙系统的稳态失调 ;检测红细胞胞浆钙系统有助于对窒息复苏后缺氧缺血性脑病的早期诊断。

Objective:To investigate the changes and clinical value of erythrocyte cytoplasmic calcium system in newborn infants.Methods:Twentysix newborn infants with severe hypoxicischemic encephalopathy (HIE) and sixteen healthy newborn infants were included in the study.Atom spectrophotometer and the improved DavidDufilho′s method were used to measure the contents and activity of total calcium,free calcium,Ca 2+ Mg 2+ ATPase and Na +K +ATPase in erythrocytic cytoplasma.Results:The contents of total calcium 〔(3 79±0 14)×10 -3 mmol/L〕 and free calcium〔(3 04±0 52)×10 -3 g/L〕 in erythrocytic cytoplasm increased significantly in the early stage of HIE( P <0 05 or P <0 001),while the activity of Ca 2+ Mg 2+ ATPase 〔(17 67 ±9 69) pmol·g -1 Hb·h -1 〕 and Na +K +ATPase〔(5 99±4 31) pmol·g -1 Hb·h -1 〕 decreased (all P <0 001).Conclusions:There is maladjustment of erythrocytic cytoplasmic calcium system during HIE.The examination of erythrocytic cytoplasmic calcium system may be useful to diagnose the HIE at early stage.