窒息新生儿血浆神经肽Y测定及临床意义

Plasma Neuropeptide Y Level in Neonates with Asphyxia

摘要:

目的：研究窒息新生儿血浆神经肽Y(NPY)及β内啡肽(βEP)的含量，探讨它们与新生儿窒息及窒息后脑损伤的关系。方法：采用放射免疫分析法测定37例窒息新生儿及12例健康新生儿(对照组)血浆NPY及β－EP的含量，同时行头颅CT检查，并测定脑实质CT值。结果：重度窒息组血浆NPY及β EP明显高于对照组［(1.85±1.10) μg/L vs (0.04±0.03) μg/L，(2.0 3±1.45)μg/L vs (0.06±0.04) μg/L］，差异有显著性(P<0.01)；轻度窒息组NPY及β EP［(0.47±0.38) μg/L，(0.34±0.33)μg /L］低于重度窒息组(P<0.01)，但高于对照组(P<0.01)。轻、重度窒息组脑CT值水平分别为(15.60±2.20) Hu和(13.08±2.18) Hu，均低于正常对照组［(20.16±2.66) Hu］(P<0.01)；其中重度窒息组脑CT值低于轻度窒息组(P<0.01)。重度窒息组NPY和β EP呈正相关(r=0.4220，P<0.05)。结论：血浆NPY，β-EP含量及脑CT值与窒息程度密切相关。窒息越重，血浆NPY和β-EP含量越高，CT值越低。NPY，β-EP可作为观察新生儿窒息程度和窒息后脑损伤的指标。

Abstract:

OBJECTIVE: To study plasma neuropeptide Y (NPY) and β Endorphin (β EP) levels in neonates with asphyxia and to explore the relationship between the two indexes and the degrees of asphyxia, as well the post asphyxia brain damage.METHODS: The plasma levels of NPY and β EP were measured in 37 asphyxia and 12 normal neonates by radio immunoassay. The cerebral CT scan was taken and the CT values were measured. RESULTS: The plasma levels of NPY and β EP in the severe asphyxia neonates were much higher than those of the normal ones [( 1.85 ± 1.10 ) μg/L vs ( 0.04 ± 0.03 ) μg/L and ( 2.03 ± 1.45 ) μg/L vs ( 0.06 ± 0.04 ) μg/L respectively; P< 0.01 ]; also higher than those of the mild ones [( 0.47 ± 0.38 ) and ( 0.34 ± 0.33 ) μg/L respectively] (P< 0.01 ). There were significant differences in the levels of NPY and β EP between the mild asphyxia neonates and the normal neonates (P< 0.01 ). The CT values of the mild and severe asphyxia neonates [( 15.60 ± 2.20 ) and ( 13.08 ± 2.18 ) Hu] were obviously lower than that of the normal neonates [( 20.16 ± 2.66 ) Hu] (P< 0.01 ). The CT value of the severe asphyxia neonates group was obviously lower than that of the mild ones (P< 0.01 ). A positive correlation was found between NPY and β EP levels in the severe asphyxia neonates (r= 0.4220 ,P< 0.01 ). CONCLUSIONS: The plasma levels of NPY and β EP and cerebral CT value were closely related with the degrees of asphyxia. The more severe the asphyxia , the higher the plasma levels of NPY and β EP, and the lower the CT value. The plasma NPY and β EP may be used as the markers in evaluating the degrees of neonatal asphyxia and post asphyxia brain damage.