缺氧性肺动脉高压新生儿血清HIF-1α、ET-1及Ca2+变化及意义

Serum levels of HIF-1α, ET-1 and Ca2+ in neonates with hypoxic pulmonary hypertension

摘要:

目的：探讨血清缺氧诱导因子-1α（HIF-1α）、内皮素-1（ET-1）及血清钙（Ca2+）水平在新生儿缺氧性肺动脉高压（HPH）中的变化及意义。方法：HPH组75例（轻度29例、中度25例、重度21例），对照组为非HPH住院新生儿22例，所有新生儿均于生后24 h内行超声心动图测定肺动脉收缩压（PASP），用ELISA法测定血清HIF-1α、ET-1水平，离子选择电极法测定血清Ca2+浓度。结果：HPH 3组患儿血清HIF-1α及ET-1水平较对照组明显增高（P<0.01），并随PASP增加而递增，分别和PASP呈正相关(rHIF-1α=0.75, P<0.01；rET-1=0.56, P<0.05)；重度HPH患儿血清Ca2+水平明显低于对照组（P<0.05），HPH患儿血清Ca2+水平与PASP无相关性。结论：HPH新生儿血清HIF-1α、ET-1水平与PASP存在相关性，HIF-1α、ET-1参与了HPH的发生，重度HPH血清Ca2+水平较对照组明显降低，提示血清Ca2+在重度HPH的形成过程中发挥了一定的作用。

Abstract:

OBJECTIVE: To study the changes and significance of serum hypoxia-inducible factor-1α (HIF-1α), endothelin-1 (ET-1) and calcium (Ca2+) levels in neonates with hypoxic pulmonary hypertension (HPH). METHODS: Seventy-five neonates with HPH (29 mild, 25 moderate and 21 severe) and 22 hospitalized neonates with non-HPH (control group) were enrolled. Pulmonary artery systolic blood pressure (PASP) was measured by bedside echocardiography within 24 hrs after birth. Serum levels of HIF-1α and ET-1 were measured using ELASA. Serum Ca2+ concentrations were measured with ion selective electrode. RESULTS: Serum levels of HIF-1α and ET-1 in the HPH group increased significantly compared with those in the control group (P<0.01), and were positively related with PASP (Rhif-1α=0.75, P<0.01; Ret-1=0.56，P<0.05). Serum Ca2+ levels in neonates with severe HPH were significantly lower than those in the control group (P<0.05). There were no correlation between serum Ca2+ levels and PASP. CONCLUSIONS: Serum HIF-1α and ET-1 levels are positively related with PASP in neonates with HPH, suggesting that serum HIF-1α and ET-1 may be involved in the occurrence of neonatal HPH. Serum Ca2+ levels are reduced in severe neonates with HPH, suggesting that serum Ca2+ may play a role in the occurrence of severe HPH.