新生儿窒息血浆血管活性肠肽的变化及纳洛酮对其影响的研究

目的 :了解窒息新生儿血浆血管活性肠肽 (VIP)的变化 ,探讨VIP与窒息脑损伤的关系及纳洛酮对VIP的影响。方法 :窒息新生儿 68例 ,随机分为窒息治疗组 (A组 ) 3 2例 ,窒息对照组 (B组 ) 3 6例。正常对照组 (C组 ) 2 0例。于入院时和入院 72小时用放免方法测定三组病人血浆VIP浓度。A组于第一次采血后给纳洛酮三天 ,余治疗与B组基本相同。结果 :①A组和B组入院时VIP均明显高于正常对照组 (P <0 0 1) ,治疗 72小时后A组VIP明显下降 ,与正常对照组比较差异无显著意义 (P >0 0 5 ) ;B组虽有下降 ,但仍高于正常对照组 (P <0 0 5 )。②重度窒息组与轻度窒息组血浆VIP比较 ,前者高于后者 (入院时P <0 0 1,入院 72小时P <0 0 5 ) ;③A组和B组缺氧缺血性脑病 (HIE)发生率比较 ,前者低于后者 (P <0 0 5 ) ;④发生HIE组与未发生HIE组血浆VIP比较 ,前者高于后者 (P <0 0 5 )。结论 :VIP参与窒息新生儿的病理生理变化 ,且与HIE的发生密切相关 ;纳洛酮可降低HIE的发生率 ,可能与降低VIP有关

Changes of plasma vasoactive intestinal polypeptide in asphyxial newborn and effects of naloxone on it

Objective: To study the changes of plasma vasoactive intestinal polypeptide (VIP) in asphyxial newborn and to explore the relationship between VIP and hypoxic ischemic encephalopathy(HIE) and the effects of naloxone(Nal) on VIP.Methods: 68 cases of asphyxial newborn were randomly classified into treat group(A,n=32) and control group(B,n=38).The therapy of group A was generally the same as that of group B except for the giving Nal in group A.20 cases were set as normal control group(C).The plasma VIP of the three groups were tested by radioinnunoassay.Results: ①The VIP of group A and group B were notably higher than that of group C when taken in hospital ( P <0.05);the VIP of group A decreased after 72 h,and the difference was of no statistical significance when compared with group C( P <0.05);the VIP of group B was still higher than that of group c( P <0.05)?②The VIP of serious asphyxia was higher than that of the slight asphyxia( P <0.01,first day; P <0.05,72 h)③The rate of HIE in group A was lower than that of group B( P <0.05).④The VIP of HIE was higher than that of non HIE( P <0.05).Conclusion: VIP involves in the pathophysiology of asphyxial newborns and has a close relation with HIE.The attack rate of HIE may be reduced by Nal due to the decrease of VIP.