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目的 了解血浆内皮素 (ET 1)、降钙素基因相关肽 (CGRP)和心钠素 (ANF)在新生儿心力衰竭时的作用和地位。方法 放射性同位素免疫分析法直接测定 2 8例心力衰竭新生儿不同病程时血浆中ET 1、CGRP和ANF含量 ,并与 2 0例正常新生儿对比。结果 心衰发生时ET 1、CGRP、ET 1/CGRP、ET 1/ANF均明显高于对照组 (P <0 0 1、P <0 0 5、P <0 0 1、P <0 0 1) ,ANF水平两组间无明显差异 (P >0 0 5 ) ;心衰纠正后 ,ET 1水平迅速下降 ,而CGRP和ANF水平则持续增长 ,ET 1/CGRP、ET 1/ANF明显降低 (P <0 0 1、P <0 0 1) ,至 3～ 4天方逐渐恢复正常 ;死亡患儿临终前ET 1、ET 1/CGRP、ET 1/ANF维持在高水平。而CGRP、ANF则均处于较低水平。结论 ET 1、CGRP和ANF等均可能与新生儿心力衰竭的病理机制有关 ,其水平的动态变化可作为判断临床转归的重要参考指标。
Objective To investigate the role and status of plasma endothelin (ET 1), calcitonin gene related peptide (CGRP) and atrial natriuretic peptide (ANF) in neonatal heart failure. Methods Radioisotope immunoassay was used to directly determine the levels of plasma ET 1, CGRP and ANF in 28 neonates with heart failure and compared with 20 normal neonates. Results The levels of ET 1, CGRP, ET 1 / CGRP and ET 1 / ANF in patients with heart failure were significantly higher than those in the control group (P <0.01, P <0.05, P <0.01, P <0.01) (P> 0.05). After correction of heart failure, the level of ET 1 decreased rapidly, while the level of CGRP and ANF continued to increase. The levels of ET 1 / CGRP and ET 1 / ANF were significantly decreased (P <0 0 1, P <0.01). The levels of ET 1, ET 1 / CGRP and ET 1 / ANF were still high at 3 to 4 days before death. The CGRP, ANF are at a low level. Conclusions ET 1, CGRP and ANF may be related to the pathological mechanism of neonatal heart failure. The dynamic changes of ET 1, CGRP and ANF may be used as important reference indexes in judging clinical outcome.