神经肽Y在子痫前期患者及新生儿缺血缺氧性脑病患儿中的表达及意义

Expression and significance of neuropeptide Y in patients with preeclampsia and neonates with hypoxic-chemic encephalopathy

目的 探讨神经肽Y在子痫前期患者血浆及新生儿血浆中的浓度与子痫前期预后及新生儿结局的关系.方法 选择2011年12月至2012年6月在烟台毓璜顶医院产科住院的子痫前期患者46例作为子痫前期组,完全随机选择同期住院的孕晚期无产科合并症及并发症的正常妊娠孕妇50例作为正常妊娠组.比较2组受试者分娩前、分娩后72 h血浆神经肽Y含量;随访子痫前期组患者产后12周血压恢复情况,并与分娩后神经肽Y下降值之间做相关性分析;新生儿出生后1h内检测静脉血浆神经肽Y含量,对新生儿随访1周,比较发生新生儿缺血缺氧性脑病（HIE）患儿与其余正常新生儿神经肽Y水平的差异,并分析HIE患儿血浆神经肽Y水平与产前母体神经肽Y水平的相关性.结果 子痫前期组分娩前及分娩后72 h神经肽Y含量分别为（137 ±33）、（107±17） ng/L,明显高于正常妊娠组的（76±6）ng/L及（71±6）ng/L,差异有统计学意义（P＜0.01）;且子痫前期组分娩前神经肽Y水平明显高于分娩后,差异有统计学意义（P＜0.01）.产后随访12周,子痫前期患者血压恢复至正常所用的平均时间为（10 ±4）d,分娩后神经肽Y下降均值为（32±8）ng/L,二者存在明显负相关（r=-0.789,P＜0.01）.子痫前期组HIE发生率明显高于正常妊娠组新生儿,差异有统计学意义[15.2％ （7/46）比4.0％ （2/50）,P＜0.05].HIE患儿及相应产前母体神经肽Y的水平明显高于正常新生儿及相应产前母体神经肽Y水平,差异有统计学意义[（145±30） ng/L比（113±31） ng/L、（132±18） ng/L比（109±28） ng/L,P＜0.05].HIE患儿血浆神经肽Y水平与产前母体神经肽Y水平存在明显正相关（r =0.612,P＜0.05）.结论 神经肽Y可能参与子痫前期的发病,其变化与子痫前期母儿预后有直接关系,可作为预测新生儿结局及子痫前期患者分娩后情况的重要指标之一.

Objective To explore expression and significance of neuropeptide Y（NPY） in patients with preeclampsia and neonates with hypoxic-ischemic encephalopathy.Methods Forty-six cases preeclampsia patients in Yantai Yuhuangding hospital from December 2011 to June 2012 were selected as preeclampsia group.Forty cases normal pregnant women without obstetric complications were randomly selected as normal pregnancy group.The plasma levels of neuropeptide Y were compared between 2 groups before childbirth and 72 h after childbirth.After 12 weeks of treatment,the blood pressure recovery in preeclampsia group was followed up.The content of serum NPY in venous blood was detected within 1 h after birth.The levels of neuropeptide Y in neonates with hypoxic-ischemic encephalopathy（HIE） and other normal neonates were compared;the correlation between the levels of plasma NPY in children with HIE and the levels of prenatal maternal was analyzed.Results Seventy two hours before and after childbirth,content of NPY in preeclampsia group [（137 ± 33）,（107 ± 17） ng/L,respectively] was significantly higher than that in the normal pregnancy group [（76 ±6） ng/L and （71 ±6）ng/L] （P 〈0.01）;before childbirth the level of NPY in preeclampsia group was significantly higher than after childbirth（P 〈 0.01）.The significant negative correlation was found regarding the mean declining value of NPY before and after childbirth （r =-0.789,P 〈 0.01）.Incidence of HIE in preeclampsia group was significantly higher than in normal pregnancy group[15.2% （7/46） vs 4.0% （2/50）,P 〈0.05];NPY levels in newborns with HIE and mother prenatal serum were significantly higher than those in normal newborns [（145 ± 30）ng/L vs （113 ± 31）ng/L,（132 ±18）ng/L vs （109 ±28） ng/L,P 〈0.05].NPY level of newborns with HIE was correlated with prenatal maternal serum levels （r =0.612,P 〈 0.05）.Conclusion NPY may be involved in the pathogenesis of preeclampsia;the level of NPY is directly related to the preeclampsia;NPY can be used as an important indicator of neonatal outcome and preeclampsia patients after parturition.