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目的:探讨血浆内皮素-1(ET-1)在新生儿缺氧缺血性脑病(HIE)中病理生理变化及与经皮动脉血氧饱和度(Tc-SaO2)的关系。方法:用放射免疫法测定60例HIE患儿ET-1水平,与25例正常新生儿进行对照,同期探讨60例HIE患儿ET-1变化与Tc-SaO2间的相关性。结果:轻度HIE组血浆ET-1水平高于对照组,中重度HIE组显著高于轻度HIE组。轻、中重度HIE患儿Tc-SaO2均降低,尤以中重度HIE组Tc-SaO2明显而持续降低。提示血浆ET-1水平变化与HIE严重程度呈正相关,与Tc-SaO2呈负相关。结论:内皮素不但参与HIE的病理生理过程,而且ET-1水平变化为临床评估HIE脑损伤程度和预后提供客观依据。及早纠正低氧血症是防止HIE病情加重的重要措施
Objective: To investigate the relationship between plasma endothelin-1 (ET-1) pathophysiology and neonatal hypoxic-ischemic encephalopathy (HIE) and its relationship with percutaneous arterial oxygen saturation (Tc-SaO2). Methods: ET-1 levels in 60 children with HIE were measured by radioimmunoassay and compared with 25 normal newborns. The correlation between ET-1 level and Tc-SaO2 in 60 HIE children was investigated. Results: The plasma levels of ET-1 in mild HIE group were significantly higher than those in control group, moderate and severe HIE group was significantly higher than mild HIE group. Tc-SaO2 in both mild and moderate HIE children was decreased, especially in moderate and severe HIE group Tc-SaO2 significantly decreased. It is suggested that there is a positive correlation between the level of plasma ET-1 and the severity of HIE, but negatively correlated with Tc-SaO2. Conclusion: Endothelin is not only involved in the pathophysiological process of HIE, but also the change of ET-1 level provides an objective basis for clinical evaluation of the degree and prognosis of HIE brain injury. Early correction of hypoxemia is an important measure to prevent HIE exacerbations