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背景:缺氧血性脑病(hypoxic-ischemicencephalopathy,HIE)是新生儿死亡和致残的重要原因之一,但其发病机制仍不十分清楚。目的:研究HIE患儿血浆神经肽Y与神经降压素(neurotensin,NT)变化及其对脑血流动学的影响,以探讨HIE的发病机制,为进一步改善HIE的预后提供理论依据。设计:非随机对照的实验研究。地点、对象和方法:研究对象来源于首都医科大学附属北京妇产医院,用放射免疫法检测40例HIE患儿及40例正常新生儿脐血及生后1,3和7d血浆神经肽Y与NT的动态变化,由北京东亚免疫技术研究所负责检测。同时于生后24h内静脉取血后即刻应用彩色脉冲多普勒超声检测其大脑中动脉的血流动学变化,包括收缩期峰值流速、舒张期末血流速度、时间平均流速、波动指数与阻力指数等。主要观察指标:HIE患儿血浆神经肽Y、血浆NT的动态变化,脑血流动力学变化并与正常新生儿比较;不同程度HIE第1天血浆神经肽Y、NT水平比较。结果:HIE患儿脐血与生后第1天外周血神经肽Y显著高于正常新生儿,分别为(615.5±130.7),(355.9±57.4)ng/L和(199.1±63.2),(214.4±58.0)ng/L(t=7.22,4.68,P<0.01),至生后第3天时降至正常对照组水平,分别为(251.1±69.9)和(232.5±85.5)ng/L(P>0.05)。而脐血与外周血NT在生后1周内均显著高于正常新生儿(t=6.61
BACKGROUND: Hypoxic-ischemic encephalopathy (HIE) is one of the important causes of neonatal death and disability. However, its pathogenesis is still unclear. Objective: To study the changes of plasma neuropeptide Y and neurotensin (NT) in children with HIE and its effect on cerebral hemoemisis in order to explore the pathogenesis of HIE and provide theoretical basis for further improving the prognosis of HIE. Design: Non-randomized controlled experimental study. Location, Subjects and Methods: The subjects were from Beijing Maternity Hospital Affiliated to Capital Medical University. The radioimmunoassay was used to detect plasma neuropeptide Y in 40 HIE infants and 40 normal neonates and 1,3 and 7 days after birth NT dynamic changes by the Beijing East Asia Institute of Immunology is responsible for testing. At the same time, the hemodynamic changes of the middle cerebral artery were detected by color Doppler sonography immediately after venous blood was taken within 24 hours after birth, including the peak systolic flow velocity, the diastolic flow velocity, the average flow velocity, the fluctuation index and the resistance index Wait. MAIN OUTCOME MEASURES: The plasma levels of neuropeptide Y and plasma NT in children with HIE and the changes of cerebral hemodynamics were compared with those of normal newborns. The level of plasma neuropeptide Y and NT in the first day of HIE were compared. Results: The levels of neuropeptide Y in cord blood of HIE children and those on the first day after birth were significantly higher than those of normal neonates (615.5 ± 130.7, 355.9 ± 57.4 and 199.1 ± 63.2, and 214.4 (251.1 ± 69.9) and (232.5 ± 85.5) ng / L, respectively, on the 3rd day after birth (P> 0.05, P <0.01) 0.05). The cord blood and peripheral blood NT within 1 week after birth were significantly higher than normal newborns (t = 6.61