一氧化碳在新生儿缺氧缺血性脑病中的作用

Role of Carbon Monoxide in Neonatal Hypoxic Ischemic Encephalopathy

摘要:

目的：探讨内源性一氧化碳(CO)在新生儿缺氧缺血性脑病(HIE)中的作用。方法：32例HIE新生儿(轻度10例，中度16例，重度6例)于急性期(3 d内)及恢复期(生后第10天)检测血浆CO水平，生后5～7 d进行颅脑CT扫描检查确定脑损害程度。观察血浆CO在急性期、恢复期的动态变化及与病情、脑损害程度的关系。30例正常新生儿为对照组。结果：HIE新生儿轻、中、重度组急性期血浆CO水平分别为(1.34±0.88) mg/L，(1.68±1.25) mg/L，(2.79±0.96) mg/L，对照组为(1.16±0.82) mg/L。除轻度组外，中、重度组明显高于对照组(P＜0.05 或 0.01＝，重度组明显高于轻、中度组(P＜0.01 或 0.05＝，CO水平随脑损害程度加重而增高；恢复期轻、中、重度组血浆CO水平均降至正常，与对照组比较，差异无显著意义(P>0.05)。结论：血浆CO水平与HIE病情及脑损害严重程度密切相关，CO可能在新生儿HIE的发病过程中具有重要意义。

Abstract:

OBJECTIVE: To study the role of carbon monoxide (CO) in the pathogenesis of neonatal hypoxic ischemic encephalopathy (HIE).METHODS: The plasma CO level was detected in 32 newborns with HIE (10 cases of mild HIE, 16 cases of moderate HIE and 6 cases of severe HIE) in the acute and recovery phases. The brain CT scan was perfomed in 32 cases 5-7 days after birth to assess the degree of brain injury. Thirty healthy neonates served as controls. RESULTS: In the acute phase, the plasma CO levels of the moderate and severe HIE infants [( 1.68 ± 1.25 ) and ( 2.79 ± 0.96 ) mg/L, respectively] were significantly higher than that of the normal controls [( 1.16 ± 0.82 ) mg/L]. The plasma CO level of the severe HIE infants was significantly higher than that of the mild and moderate ones. Moreover, the level of CO significantly increased in the neonates with brain damage compared with that in the patients without brain injury. In the recovery phase, the CO level in all the HIE neonates decreased to the normal level. CONCLUSIONS: The plasma CO level is related to the severity of neonatal HIE and the degree of brain damage. CO might play an important role in the pathogenesis of neonatal HIE.