内皮素-1在新生儿缺氧缺血性脑病中的变化及意义

Endothelin-1 Concentrations in Neonates with Hypoxic-ischemic Encephalopathy

摘要:

目的 探讨内皮素 - 1(ET - 1)在新生儿缺氧缺血性脑病 (HIE)中的变化及意义。方法 采用放射免疫法测定 2 0例正常小儿和 5 2例HIE患儿的血清及脑脊液 (CSF)中ET 1水平 ,并将HIE患儿分为轻、中、重 3组。结果 正常对照组血清ET 1为 6 8.71± 12 .0 3ng/L。轻、中、重度HIE血清ET 1在急性期分别为 98.38±12 .82ng/L ,10 7.2 1± 18.5 6ng/L ,119.5 6± 14.6 9ng/L ;恢复期分别为73.44± 11.79ng/L ,75 .73± 11.38ng/L ,83.92± 15 .99ng/L。HIE患儿急性期血清ET 1水平显著高于恢复期及正常对照组 ,P <0 .0 1。轻、中、重度HIE患儿急性期CSF中ET 1水平分别为 43.79± 7.14ng/L ,5 1.0 7± 11.19ng/L ,6 1.86± 13.5 5ng/L ;恢复期CSF中ET 1水平分别为 30 .79± 4.42ng/L ,33.0 7± 4.84ng/L ,39.5 0± 5 .5 6ng/L。急性期CSF中ET 1水平显著高于恢复期 ,均P <0 .0 1,且血清及CSF中ET 1水平与病情轻重密切相关。急性期HIE患儿血清和CSF中ET 1水平 ,重度组明显高于正常对照组P <0 .0 1及P <0 .0 5 ,尤以重度组升高显著 ;恢复期轻 ,中度组ET 1水平降至正常 ,而重度组仍维持在较高水平 ,且血清及CSF中ET 1水平与病情轻重密切相关。血清和CSF中ET 1水平与 1分钟Apgar评分呈显著负相关。 结论 ET 1在HIE的发

Abstract:

Objective To investigate changes in endothelin 1 (ET 1) levels in neonates with hypoxic ischemic encephalopathy (HIE). Methods Serum and CSF ET 1 levels in 20 normal neonates and 52 HIE neonates were assayed using radioimmunoassay and the 52 HIE neonates were divided into mild, moderate, and severe groups. Results Serum ET 1 levels were 68.71±12.03 ng/L in the normal control group. In the aucte phase, serum ET 1 levels in infants with mild, moderate, and severe HIE were 98.38±12.82 ng/L, 107.11±18.56 ng/L, 119.56±14.69 ng/L, respectively; and in the remission stage they were 73.44±11.79 ng/L, 75.73±11.38 ng/L, 83.92±15.99 ng/L, respectively. Serum ET 1 levels were significantly increased in the acute phase compared to the remission stage and the controls (P<0.01). In the acute phase, CSF levels in infants with mild, moderated, and severe HIE were 43.79± 7.14 ng/L , 51.07±11.19 ng/L, 61.86±13.55 ng/L, respectively; and in the remission stage they were 30.79± 4.42 ng/L , 33.07±4.84 ng/L, 39.50±5.56 ng/L, respectively. In the acute phase, CSF ET 1 levels in infants with moderate and severe HIE were much higher than those in the controls (P<0.01 and P<0.05), although in the recovery phase, the ET 1 levels of the mild and moderate HIE groups decreased to normal. ET 1 levels in severe HIE infants remained at a high level. Serum and CSF ET 1 levels were significantly correlated with the severity of HIE and were negatively correlated with 1 minute Apgar score. Conclusions ET 1 may play an important role in the pathogenesis of HIE.