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目的研究新生儿窒息后血浆褪黑素(MT)水平的变化,阐明褪黑素在新生儿窒息及缺氧缺血性脑病(HIE)发生发展过程中的作用,并为临床应用提供依据。方法选择正常足月新生儿12名的脐动脉血标本为对照组。足月新生儿窒息病例36例为观察组,其中轻度窒息12例,重度窒息24例,重度窒息中并发HIE12例;分别于急性期(生后24h内)和恢复期(生后第7天)采股静脉血标本,用酶联免疫分析法检测血浆褪黑素水平。结果窒息急性期、恢复期与正常对照组相比,褪黑素水平升高有统计学意义(P<0·05和P<0·01);窒息恢复期与急性期相比,褪黑素水平升高有统计学意义(P<0·01)。无HIE组急性期与对照组相比,褪黑素水平变化无统计学意义(P>0·05);其余各组与对照组相比,褪黑素水平升高均有统计学意义(P<0·01)。无HIE组恢复期与急性期相比及急性期HIE组与无HIE组相比,褪黑素水平升高有统计学意义(P<0·01);HIE组恢复期与急性期相比及恢复期HIE组与无HIE组相比,褪黑素水平变化无统计学意义(P>0·05)。结论新生儿窒息后及并发HIE时血浆褪黑素水平均升高,提示对机体有一定的保护作用。
Objective To study the change of plasma melatonin (MT) level after neonatal asphyxia and to elucidate the role of melatonin in the development of neonatal asphyxia and hypoxic-ischemic encephalopathy (HIE) and to provide basis for its clinical application. Methods Twelve naive umbilical arterial blood samples from normal full-term neonates were selected as control group. Thirty-six neonates with full-term neonatal asphyxia were randomly divided into observation group, 12 cases with mild asphyxia, 24 cases with severe asphyxia and 12 cases with severe hypopyemia complicated by HIE. The acute phase (within 24 hours after birth) and recovery (7 days after birth) ) Collecting femoral venous blood samples, using enzyme-linked immunosorbent assay to detect plasma melatonin levels. Results Compared with the normal control group, the increase of melatonin level in asphyxia acute phase and convalescent phase had statistical significance (P <0.05 and P <0.01). Compared with acute phase, melatonin The level of increase was statistically significant (P <0.01). Compared with the control group, there was no significant difference in the level of melatonin in the acute phase without HIE (P> 0.05), and the levels of melatonin in the other groups were significantly increased compared with the control group (P <0 · 01). Compared with the acute phase and no HIE group, the level of melatonin in the acute phase of HIE group was significantly higher than that in the non-HIE group (P <0.01) There was no significant difference in melatonin level between convalescent HIE group and non-HIE group (P> 0.05). Conclusions The levels of plasma melatonin after neonatal asphyxia and concurrent HIE are all elevated, suggesting that they may have some protective effects on the body.