新生儿缺氧缺血性脑病血浆内皮素-1及脑血流动力学变化

探讨新生儿缺氧缺血性脑病（HIE）血浆内皮素-1（ET-1）及脑血流变化的规律。方法采用放射免疫法检测92例HIE血浆ET-1浓度，与对照组对较，应用经颅彩色多谱勒（TCD）对32例HIE脑血流参数及结构形态进行了检测。结果HIE急性期血浆ET－1均有增高，重度增高显著，与对照组有显著差异，恢复期降低；TCD与对照组比较显示脑内各血管血流减低，阻力及搏动指数增高。结论HIE损伤大脑血管内皮细胞，使ET-1释放增加，与HIE损伤程度呈正相关。严重HIE时脑血管痉挛、阻力增加，应用TCD检测脑血流也有助于指导治疗及评估预后。

Clinical study of plasma endothelin-1 and hemodynamicchanges in cerebral blood flow in neonatal hypoxic-ischemic encephalopathy

To study the changes of the plasma endothelin-1 (ET-1)levels and the regularity of cerebral blood flow alterations in neonatal hypoxic-ischemic encephalopathy (HIE).Method By Radio-immunoassay the ET-1 density of plasma in 92 HIE newborn cases were detected and compared with that of 56normal babies in control group. The cerebral blood flow data and cerebral structure of 32 cases were detected by transcranial color Doppler ultrasound (TCD).Result The plasma endothelin-1 level increased greatly in different kinds of HIE newborns. especially among those seriously injured patients. TCD showed the decrease in cerebral blood flow. while the cerebral blood vessel resistance index (RI) and pulse index (PI) increaded.Conclusion The endotheliocytes of cerebral blood vessel are injured by HIE and release more ET-1. The ET-1 density level is positively correlated to HIE injury grade. A seriously HIE injured patient may have cerebral vasospasm and increasing resistance. Detecting cerebral blood flow by TCD can be helpful to the therapy and prognosis.