新生儿缺氧缺血性脑病血浆一氧化氮及一氧化氮合成酶水平对预后判断的意义

目的探讨新生儿缺氧缺血性脑病 (hypoxic-ischemic encephalopathy , HIE)时一氧化氮、一氧化氮合成酶 (Nitrogen monoxide synthase , NOS)水平的变化及其对预后判断及恢复期指导的意义. 方法 采用比色等方法测定 32例 HIE患儿及 30例正常新生儿血浆一氧化氮、一氧化氮合成酶活性水平. 结果 正常对照组一氧化氮、 NOS水平分别为 (72.84± 12.35) μ mol/L和 (0.203± 0.05) kU/g, HIE组为 (129.80± 32.66) μ mol/L和 (0.352± 0.124) kU/g;其中轻度 HIE为 (105.65± 36.30) μ mol/L和 (0.289± 0.09) U/mg;中度 HIE为 (135.03± 24.40) μ mol/L和 (0.325± 0.16) kU/g;重度 HIE组为 (144.55± 26.32) μ mol/L和 (0.364± 0.01) kU/g. HIE急性期一氧化氮、 NOS水平校正常新生儿明显升高 (t=- 8.97, P< 0.01),中、重度 HIE升高更显著 (t=- 10.62,- 12.01,P< 0.01),中、重度 HIE患儿较轻度 HIE患儿升高明显 (t=- 2.12,- 2.92,P< 0.05,P< 0.01).中、重度 HIE之间则无明显差别. 结论一氧化氮、 NOS水平高低与 HIE患儿脑损伤程度和预后有关,可作为判断 HIE患儿病情恢复及预后的指标之一.

Significance of the changes of serous nitric oxide and nitrogen monoxide synthase levels of neonatal hypoxic-ischemic encephalopathy in prognosis judgments

AIM:To discuss the level changes of nitric oxide(NO) and nitrogen monoxide synthase(NOS) in neonatal hypoxic-ischemic encephalopathy (HIE) and its significance on prognosis judgments and restoration supervision. METHODS:Color matching method, and etc. were introduced in detecting the serous NO and NOS levels of 32 HIE cases as well as 30 normal neonates. RESULTS:The NO and NOS levels of the control group were(72.84± 12.35)μ mol/L and(0.203± 0.05) kU/g respectively as well as(129.80± 32.66) μ mol/L and(0.352± 0.124) kU/g in the HIE group,in which of (105.65± 36.30) μ mol/L and(0.289± 0.09) U/mg in slight HIE cases,(135.03± 24.40) μ mol/L and(0.325± 0.16) kU/g in moderate HIE cases, and (144.55± 26.32)μ mol/L and (0.364± 0.01) kU/g in severe HIE cases respectively.NO and NOS levels were significantly higher in acute HIE than that of in normal neonates(t=- 8.97, P<0.01), while were more significantly higher in moderate and severe HIE cases (t=- 10.62, - 12.01, P<0.01). There was significant difference between slight and moderate, severe HIE cases (t=- 2.12,- 2.92,P< 0.05,P< 0.01),but there was no significant difference between moderate and severe HIE cases. CONCLUSION:The levels of NO and NOS relate to the degree of the cerebral damages in HIE patients as well as the prognosis,which can be used as one of the indices in the judgment of the restoration and prognosis in HIE patients.