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目的:探讨新生儿缺氧缺血性脑病(hypoxic-ischemicencephalopathy,HIE)时一氧化氮、一氧化氮合成酶(Nitrogenmonoxidesynthase,NOS)水平的变化及其对预后判断及恢复期指导的意义。方法:采用比色等方法测定32例HIE患儿及30例正常新生儿血浆一氧化氮、一氧化氮合成酶活性水平。结果:正常对照组一氧化氮、NOS水平分别为(72.84±12.35)μmol/L和(0.203±0.05)kU/g,HIE组为(129.80±32.66)μmol/L和(0.352±0.124)kU/g;其中轻度HIE为(105.65±36.30)μmol/L和(0.289±0.09)U/mg;中度HIE为(135.03±24.40)μmol/L和(0.325±0.16)kU/g;重度HIE组为(144.55±26.32)μmol/L和(0.364±0.01)kU/g。HIE急性期一氧化氮、NOS水平校正常新生儿明显升高(t=-8.97,P<0.01),中、重度HIE升高更显著(t=-10.62,-12.01,P<0.01),中、重度HIE患儿较轻度HIE患儿升高明显(t=-2.12,-2.92,P<0.05,P<0.01)。中、重度HIE之间则无明显差别。结论:一氧化氮、NOS水平高低与HIE患儿脑损伤程度和预后有关,可作为判断HIE患儿病情恢复及预后的指标之一。
Objective: To investigate the changes of nitric oxide and nitric oxide synthase (NOS) levels in neonates with hypoxic-ischemic encephalopathy (HIE) and their significance for prognosis and recovery. Methods: The levels of plasma nitric oxide and nitric oxide synthase in 32 neonates with HIE and 30 normal neonates were determined by colorimetric method. Results: The levels of nitric oxide and nitric oxide in the normal control group were (72.84 ± 12.35) μmol / L and (0.203 ± 0.05) kU / g respectively, and those in the HIE group were (129.80 ± 32.66) μmol / L and 0.352 ± 0.124 kU / g; mild HIE was (105.65 ± 36.30) μmol / L and (0.289 ± 0.09) U / mg respectively; moderate HIE was (135.03 ± 24.40) μmol / L and (144.55 ± 26.32) μmol / L and (0.364 ± 0.01) kU / g. In the acute phase of HIE, the levels of nitric oxide and NOS in normal newborns were significantly higher (t = -8.97, P <0.01), and those in moderate and severe HIE increased more significantly (t = -10.62, -12.01, P <0.01) , Severe HIE children with mild HIE increased significantly (t = -2.12, -2.92, P <0.05, P <0.01). There was no significant difference between moderate and severe HIE. Conclusion: The levels of nitric oxide and NOS are related to the degree of brain injury and prognosis in children with HIE, which may be used as one of the indicators to judge the recovery and prognosis of children with HIE.