摘要
目的 探讨新生儿窒息时脐血中内源性阿片肽水平的变化及作用。方法 采用放射免疫测定法测定 4 0例正常妊娠妇女 (对照组 )、33例新生儿窒息孕妇 (窒息组 )静脉血及脐动脉血中 β -内啡肽、强啡肽A1-13 和亮脑啡肽的含量。结果 ①窒息组脐血中 β -内啡肽、强啡肽A1-13 和亮脑啡肽的含量分别为 (5 6 9 5 6± 79 4 6 )ng/L、(2 98 6 3± 36 18)ng/L及 (4 98 37± 71 5 2 )ng/L ,对照组分别为 (2 5 0 90± 39 4 0 )ng/L、(10 2 5 0± 2 1 6 3)ng/L及 (32 1 5 2± 39 90 )ng/L ;与对照组相比 ,窒息组脐血中 3种阿片肽含量均显著升高 (P <0 0 1及P <0 0 5 ) ,而重度窒息组与轻度窒息组间也有显著差异 (P <0 0 5 )。②脐动脉血血气分析 :pH为 7 0± 0 1,PaO2 为 (9 0 0± 3 0 0 )mmHg ,PaCO2 为 (6 6 75± 5 2 3)mmHg ;其中 β -内啡肽含量与脐血pH、PaO2呈显著负相关 (r为 - 0 5 6 3及 - 0 6 81,P <0 0 1) ,与PaCO2 呈显著正相关 (r =0 5 2 4 ,P <0 0 1) ;强啡肽A1-13 含量与脐血pH及PaO2 呈负相关 (r为 - 0 398及 - 0 4 32 ,P <0 0 5 ) ,与PaCO2 呈正相关 (r=0 4 2 6 ,P <0 0 5 ) ;亮脑啡肽含量与脐血pH及PaO2 呈负相关 (r为 - 0 347及 - 0 383,P <0 0 5 ) ,与PaCO2 呈正相关 (r
Objective To evaluate the role of endogenous opioid peptides(EOP) in the neonatal asphyxia.Methods 33 patients with neonatal asphyxia (asphyxia group)and 40 healthy pregnant women in their third trimester(control group)were studied.The concentrations of plasma EOP (β-endorphin、dorphinA 1-13 and leu-enkephalin) were measured by radioimmunoassay.Results ①The levels of umbilical artery plasma EOP(β-endorphin,dorphin A 1-13 and leu-enkephalin) in asphyxia group were(569 46±79 46) ng/L,(298 63±36 18) ng/L and (498 37±71 52) ng/L respectively.In control group,the levels of EOP were(250 90±39 40) ng/L,(102 50±21 63) ng/L and (321 52±39 90) ng/L respectively.The levels of umbilical artery plasma EOP(β-endorphin、dorphin A 1-13 and leu-enkephalin) in asphyxia group were significantly higher than that in the control group( P <0 01, P <0 05).Compared with the slight asphyxia group, the umbilical artery plasma EOP in severe asphyxia group increased significantly ( P <0 05);②The umbilical artery blood gas analysis:pH was (7 0±0 1),PaO 2 was (9 00±3 00) mmHg, PaCO 2 was (66 75±5 23) mmHg;the levels of β-endorphin,dorphin A 1-13 and leu-enkephalin were negatively correlated with pH and PaO 2 in umbilical artery plasma( P <0 01, P <0 05),and obvious correlation were found between the three peptides and PaCO 2( P <0 05) ③In asphyxia group,the levels of maternal plasma EOP were(43 57±15 72) ng/L,(62 14±15 19) ng/L and (228 83±41 82) ng/L respectively.In control group,the levels were (36 5±9 1) ng/L,(58 72±14 63) ng/L and (199 20±37 15) ng/L respectively.There was no statistical difference in the levels of maternal plasma EOP between the control group and asphyxia group( P >0 05).Conclusion The neonatal asphyxia was associated with EOP,and the changes of EOP levels in umbilical artery plasma might play an important role in the pathophysiological changes in neonatal asphyxia. [
出处
《中国急救医学》
CAS
CSCD
北大核心
2003年第9期601-602,共2页
Chinese Journal of Critical Care Medicine
