肺出血新生儿血中一氧化氮和内皮素-1水平变化及意义

Changes and significance of nitric oxide and endothelin-1 in blood of newborns with pulmonary hemorrhage

摘要:

目的 研究一氧化氮（ＮＯ）和内皮素－ １（ＥＴ－ １） 在肺出血新生儿血中的变化及其与预后的关系。方法 用硝酸还原酶法和放射免疫法分别测定对照组（ｎ＝ １５） ，肺出血存活极期组（ 存活组，ｎ ＝ １３），肺出血恢复期组（ 恢复组，ｎ＝ １３） 和肺出血死亡组（ 死亡组，ｎ＝ ７） 四组新生儿血中ＮＯ 和ＥＴ－ １ 的水平。结果 对照组，存活组，恢复组和死亡组的ＮＯ 水平分别为６３．０ ±１０ ．７ μｍｏｌ／Ｌ，３２．０ ±７．５ μｍｏｌ／Ｌ ，６８ ．２ ±６．９ μｍｏｌ／Ｌ 和２０ ．１ ±５ ．２ μｍｏｌ／Ｌ；ＥＴ－ １ 水平分别为１９．６ ±４．０ｎｇ／Ｌ， ４３ ．０±８．９ ｎｇ／Ｌ ，２０．７ ±４ ．５ ｎｇ／Ｌ和５４．１ ±３ ．９ ｎｇ／Ｌ；ＮＯ／ＥＴ－ １ 比值分别为３ ．２１ ，０．７４，３ ．２９ 和０．３７。ＮＯ 与ＥＴ－ １ 浓度之间呈负相关，ｒ ＝ － ０．７９ （Ｐ＜０ ．０１）。各组之间差异有显著意义（ Ｐ＜０ ．０１ 或Ｐ＜ ０ ．０５） 。结论 肺出血新生儿血中ＮＯ 降低，ＥＴ－ １ 升高， 二者呈负相关，ＮＯ／ＥＴ－１ 比值降低与疾病严重程度密切相关，后者可作为肺出血患儿预后估计的指标。

Abstract:

Objective To study the changes of nitric oxide (NO) and endothelin-1 (ET-1) and the relationship between these changes and this prognosis in newborns with pulmonary hemorrhage (PH). Methods Nitric acid reductase and radioimmunoassay methods were respectively used to measure concentrations of serum NO and plasma ET-1 in group control (n=15), group survival with PH within an acute phase (survival, n=13), group survival with PH within a recovery phase (recovery, n=13) and group deadth with PH (deadth, n=7). Results The concentrations of serum NO were 63.0±10.7 μmol/L, 32.0±7.5 μmol/L, 68.2±6.9μmol/L and 20.1±5.2 μmol/L in group control, group survival, group recovery and group death respectively. The concentrations of ET-1 were 19.6 ± 4.0 ng/L, 43.0 ± 8.9 ng/L, 20.7 ± 4.5 ng/L and 54.1±3.9 ng/L respectively. The rates of NO/ET-1 were 3.21, 0.74, 3.29 and 0.37 respectively. The differences among the four groups were markedly significant.Conclusions The concentration of NO is decreased, while the concentration of ET-1 is elevated in newborns with PH.The rate of NO/ET-1 is strongly correlated with the severity of illness and may be considered as an indicator of the prognosis of PH.