新生儿缺氧缺血性脑病血NSE与ET变化及其与高压氧治疗相关性的研究

目的探讨新生儿缺氧缺血性脑病血清神经元特异性烯醇酶（ＮＳＥ）与血浆内皮素（ＥＴ）变化及高压氧治疗的作用。方法高压氧治疗以纯氧加压，压力０．０５～０．０７ ＭＰ加压 ２０ ｍｉｎ．稳压 ２０ ｍｉｎ，减压 ２０ ｍｉｎ，共历时 １ｈ，每天一次，疗程５～１０ ｄ。ＮＳＥ活性测定采用酶联免疫分析法；ＥＴ活性测定采用放射免疫分析法。结果中度ＨＩＥ患儿血清ＮＳＥ与血浆ＥＴ浓度分别为（１４．７２±４ ２６）μｇ／Ｌ（７６．１±１９．２）ｎｇ／Ｌ；重度ＨＩＥ患儿血清ＮＳＥ与血浆ＥＴ浓度分别为（１５．６４±５．８２）μｇ／Ｌ，（８２．５±２１．６）ｎｇ／Ｌ；中、重度ＨＩＥ患儿血清ＮＳＥ与血浆ＥＴ浓度显著高于对照组（分别为１２．４７± ３．４９ μｇ／Ｌ， ５６．３２± １６．７ｎｇ／Ｌ）。轻度 ＨＩＥ患儿血清 ＮＳＥ（ １３．５８± ４．５７） μｇ／Ｌ，血浆ＥＴ（６２．４± １８．５） ｎｇ／Ｌ与对照组比较无显著差异。中、重度 ＨＩＥ患儿高压氧治疗后，血清 ＮＳＥ，血浆 ＥＴ降低幅度分别为（ １．９２± ０．４６）μｇ／Ｌ，（ １２．７２± ４． ３７）ｎｇ／Ｌ，明显大于常规治疗组（ Ｐ＜ ０．０５）。结论血清 ＮＳＥ和血浆 ＥＴ是ＨＩＥ早期诊断与疗效判

Dynamic Changes of Blood NSE and ET in Infants with HIE Treated by Hyperbaric Oxygen

Objective To explore the therapeutic effects of hyperbaric oxygen on neonatal hypoxic - ischemic encephalopathy (HIE) and its potential mechanism. Methods The serum neuron specific enolase (NSE) were tested by ELISA and plasma endothlin (ET) were detected with radio - immune - assay (RIA) before and after hyperbaric oxygen therapy. Results The serum NSE and plasma ET were (14. 72 ± 4. 26)μg/L and (76. 1 ± 19. 2) ng/L in the moderate group respectively and (15. 64 ± 5. 82) μg/L and (82. 5 ± 21. 6) ng/L in the severe group respectively. The NSE and ET were increased significantly in the moderate group and the severe group as compared with the control group (12. 47 ± 3. 49 μg/L,56. 32 ± 16. 7 ng/L respectively); The NSE and ET were (13. 58 ± 4. 57) μg/L and (62. 4 ± 18. 5) ng/L. in the mild group respectively and not increased significantly with the control group. The level of NSE and ET significantly decreased after hyperbaric oxygen was engaged. Conclusions The serum NSE and plasma ET were a good discriminator for the evaluation of HIE, and its dynamic changes might be one of the potential mechanisms for the therapeutic effects of hyperbaric oxygen on HIE.