新生儿缺氧缺血性脑病与内皮素和一氧化氮的相关性研究

目的：探讨血浆内皮素（Endothelin，ET）及一氧化氮（nitric oxide，NO）在新生儿缺氧缺血性脑病(HIE)的变化及其相互关系。方法：对36例HIE患儿（轻度11例，中度15例，重度10例）分别采用放射免疫法测定血浆中ET-1，硝酸银还原法测定血浆中NO2^-/NO3^-值代表NO水平，并动态观察HIE出生1d，5d变化，设20你对照组比较。结果：HIE血浆ET-1水平中，重度组明显高于对照组，轻度组与对照组无显著差异；经治疗5d较前显著下降；轻、中度组与ET-1水平降至正常，重度组仍维持较高水平，有显著意义。NO水平HIE组高于对照组，重度组又明显高于轻度组，5d后NO水平均降至正常，与对照组比较，无显著差异。结论：HIE时因缺血缺氧ET和NO合成、释放代谢异常，功能失衡造成脑损害有关。可作为判断病情、预后的指标。

A Reseach of Mutuality of Enpothelin and Nitric Oxide Levels in Plasma of Newborn Infants with Hypoxic Ischemic Encephalopathy

Objective:To study the relationship and the changes of endothelin 1(ET 1) and nitric oxide(NO) in the plasma on hypoxic ischemic encephalopathy(HIE).Methods:In 36 newborn infants with HIE (11 cases of mild,15 cases of moderate and 10 cases of severe status),ET 1 levels in the plasma were measured by radio immunoassay both in 1 and 5 days;NO 2 -/NO 3 - level of plasma were measured with nitrate reductase.Results:At day one, the ET 1 levels of the plasma,in infants with severe HIE, were much higher than those in the controls,especially the severe cases. There was no significant difference of ET 1 levels between the mild HIE and the control infants.However,in 5 days,the ET 1 in infants with severe HIE was kept at the high level. At day one,the NO levels in the plasma of the moderate and severe HIE infants were much higher than those of the control.The NO levels of the severe HIE infants were obviously higher than those of the mild ones. In 5 day,the NO levels in all three groups of HIE infants decreased to the normal levels,which were no significantly different in comparison to the control.Conclusion:The brain damage of HIE infants might relate to the over expression of ET 1 and NO.It can be taken as an index to judge the state of illness and prognosis.