窒息新生儿脐血D-二聚体水平和红细胞膜Na~+-K~+-ATP酶活性变化

目的:分析窒息新生儿脐血pH、D-二聚体水平及红细胞膜Na+-K+-ATP酶活性变化。方法 :选择临产过程出现急性胎儿窘迫孕妇40例,其剖宫娩出新生儿以1min Apgar评分确定为正常者20例(窘迫组),出现窒息者20例(窒息组);另选无急性胎儿窘迫、同样剖宫娩出的正常新生儿20例作为对照组。取各组脐动脉血,血气分析仪检测pH值,免疫比浊法检测D-二聚体水平,定磷法检测红细胞膜Na+-K+-ATP酶活性。比较各组上述指标的差异。结果:方差分析显示,各组脐动脉血pH值、D-二聚体水平和红细胞膜Na+-K+-ATP活性差异均有统计学意义(P0.05)。窒息组脐动脉血pH值明显低于对照组和窘迫组(P均0.05),D-二聚体水平显著高于对照组和窘迫组(P均0.05),红细胞膜Na+-K+-ATP酶活性显著低于对照组与窘迫组(P均0.05);窘迫组pH值和红细胞膜Na+-K+-ATP酶活性显著低于对照组(P均0.05)。结论 :窒息新生儿纤溶和红细胞膜泵功能检测结果,可为新生儿窒息治疗措施的选择提供实验依据。

Changes of D-Dimer Content in Plasma and Na+-K+-ATPase Activity in Erythrocyte Membrane of Umbilical Cord Blood from Cases Subjected to Asphyxia Neonatorum

Objective：To analyze the changes of D-Dimer content in plasma and Na＋-K＋-ATPase activity in erythrocyte membrane of umbilical cord blood from cases subj ected to asphyxia neonatorum.Method：Forty pregnant women with acute fetal distress were divided into fetal distress group and asphyxia neonatorum group （n=20） through the evaluation with Apgar standard within 1 min.In fetal distress group,the neonatus is normal,as well as the neonatus has asphyxiation in asphyxia group.Otherwise,twenty normal pregnant women were as control group.After childbirth,the umbilical cord blood was obtained for the detection of pH values with blood-gas analy-zer,D-Dimer content in plasma and Na＋-K＋-ATPase activity in erythrocyte membrane using the methods of immu-noturbidimetry and fixing phosphorus,respectively.Results：The Apgar scores and pH values in the asphyxia neona-torum group were lowered significantly than those of the fetal distress and control group （P〈0.05）.Meanwhile,in the asphyxia group,the D-Dimer content in plasma was obviously increased,the Na＋-K＋-ATPase activity in eryth-rocyte membrane was obviously decreased that those of the fetal distress and control groups,respectively （P〈0. 05）.In addition,the pH values and Na＋-K＋-ATPase activity in erythrocyte membrane in the fetal distress group was obviously decreased than that of the control group （P〈0.05）.Conclusion：Asphyxia resulted in the fibrinolysis and decreased pump activity in erythrocyte membrane,providing experimental basis for the therapy of asphyxia neo-natorum.