摘要
目的 探讨新生儿窒息后血浆 β内啡肽 (β EP)和血管活性肠肽 (VIP)的变化 ,及纳洛酮治疗后对其的影响。方法 围产期窒息新生儿 44例 ,其中重度窒息 1 9例 ,轻度窒息 2 5例。将 44例窒息新生儿中的 32例设为实验组 (重度窒息 1 4例 ,轻度窒息 1 8例 ) ,在生后第 1天及用纳洛酮治疗后1h和 3d分别取血 ,用放射免疫技术测定血浆 β EP及VIP。另 1 2例为窒息对照组 (重度窒息 5例 ,轻度窒息 7例 )。正常对照组 1 6例。结果 生后 2 4h内窒息组患儿 β EP及VIP明显高于对照组 ,且窒息程度越重 ,两者水平越高 ,两组比较差异有显著意义 (P <0 .0 5)。重度窒息、轻度窒息 ,及非窒息对照组患儿血浆 β EP及VIP水平分别为 (1 65± 61 ) ,(91± 45) ;(1 0 1± 2 9) ,(73± 1 4 ) ;(67± 1 6) ,(64± 1 1 )ng/L。应用纳洛酮 1h后实验组患儿血浆 β EP及VIP水平均下降 ,连续用药 3d后 ,实验组 β EP[(58± 1 8)ng/L]及VIP[(50± 1 3)ng/L]明显低于窒息对照组 [分别为 (77± 1 5)、(70± 1 2 )ng/L] ,两组比较差异有显著意义 (P <0 .0 5)。而与同日龄非窒息对照组水平差异无显著意义。结论 血浆 β EP及VIP浓度与围产期窒息缺氧密切相关 ,窒息程度越重 ,β EP及VIP水平越高 ,而纳洛酮可有效降低 β
Objective To study the changes in plasma beta endorphin (β EP) and vasoactive intestinal peptide (VIP) in asphyxiated infants and the impact of naloxone on such changes. Methods Forty four infants with neonatal asphyxia (25 mild and 19 serious cases) were divided into naloxone treated asphyxia group ( n =32) and asphyxia control group ( n =12). Sixteen newborns were in non asphyxia control group. Blood samples were obtained within the first 24 hours of life for the measurement of plasma β EP and VIP levels. In naloxone treated asphyxia group, 0.05 mg/kg naloxone was given and repeated every 8 hours for a duration of 72 hours. Before naloxone treatment and 1 hour and 3 days after the treatment, blood samples were taken to measure plasma β EP and VIP levels. In non asphyxia control group blood samples were obtained at 1 hour and 4 days after birth, respectively. The plasma levels of β EP and VIP of all neonates were measured by RIA. Results Within the first 24 hours, the levels of plasma β EP and VIP were high in asphyxiated infants, and they had positive correlation with those of controls ( P <0.05). The levels of β EP and VIP were (165±61) ng/L and (91±45) ng/L in severe asphyxiated infants, (101±29) ng/L and (73±14) ng/L in mild asphyxiated infants, and (67±16) ng/L and (64±11) ng/L in non asphyxia controls, respectively. After 1 hour treatment, the levels of β EP and VIP in plasma dropped and they were lower than those of asphyxia controls. After 3 days of naloxone treatment, levels of β EP [(58±18) ng/L] and VIP [(50±13) ng/L] in naloxone treated asphyxia group were lower than those of asphyxia controls [β EP (77±15) ng/L and VIP (70±12)ng/L]. There was no significant difference in levels of β EP and VIP in plasma between naloxone treated asphyxia group and non asphyixia control group after 3 days of naloxone treatment. Conclusion The levels of β EP and VIP in plasma had a positive correlation with the severity of perinatal asphyxia. Naloxone could effectively reduce plasma β EP and VIP levels.
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2002年第6期354-356,共3页
Chinese Journal of Pediatrics
