新生儿缺氧缺血性脑病血浆内皮素1与C型利钠肽变化及其对脑血流动力学的影响

目的　研究新生儿缺氧缺血性脑病 (HIE)患儿血浆内皮素 1(ET 1)与C型利钠肽 (CNP)的变化及其对脑血流动力学的影响。方法　用放射免疫法检测 4 0例HIE患儿及 4 0例正常新生儿脐血及生后 1d、3d、7d外周血ET 1、CNP的动态变化 ;生后 2 4h内外周静脉取血后即刻应用脉冲多谱勒超声检测HIE儿大脑中动脉的血流动力学参数。结果　与正常新生儿相比 ,HIE患儿 :1.血浆ET 1、CNP显著升高 ;生后 1周末可恢复正常。 2 .脑血流阻力增加 ,血流速度减慢。 3.直线相关分析表明 ,脑血流阻力指数 (RI)与ET 1呈正相关 (r =0 .72 4　P<0 .0 0 1) ,与CNP呈负相关 (r =- 0 .776　P <0 .0 0 1)。结论　新生儿窒息后ET 1与CNP参与了HIE的病理生理过程 ,其平衡失调是HIE脑血流动力学紊乱的原因之一

The changeg of endothelin-1 and C-type natriuretic peptide in neonatal hypoxic-ischemic encephalopathy and its influence on cerebral hemodynamics

Objective To study the variation of endothelin 1(ET 1) and C type natriuretic peptide(CNP) and their influence on cerebral artery hemodynamics in neonates with hypoxic ischemic encephalopathy (HIE) .Methods The ET 1 and CNP levels in cord blood and peripheral blood were measured at the time of 1 day,3 days and 7 days after birth in HIE and healthy control group by using radioimmunoassay . The cerebral artery hemodynamics were determined by color Doppler ultrasonography on the first day immediately after the blood samples were obtained. Results 1. The ET 1 and CNP levels were significantly elevated in neonates with HIE, and returned to normal level at the end of the first week.2.The Doppler ultrasonography showed the cerebral arteries blood velocity was decreased while cerebral blood resistance was increased.3.Linear regression indicated that resistance index(RI) positively correlated with ET 1(r=0.724 P<0.001) and negatively correlated with CNP(r=-0.776 P<0.001). Conclusions The imbalance of ET 1 and CNP in asphyxiated neonates may be one of the causes of cerebral hemodynamic disturbance in neonatal HIE.