摘要
检测不同时期、不同严重程度的新生儿缺氧缺血性脑病(HIE)患儿血神经元特异性烯醇化酶(NSE)、内皮素-1(ET-1)和降钙素基因相关肽(CGRP)的含量,探讨NSE、ET-1和CGRP在新生儿HIE中的变化及其临床意义。分别于出生即刻、3天、7天采集对照组、新生儿HIE轻度组、中度组、重度组的血标本,采用放射免疫法检测新生儿CGRP、ET-1和NSE的含量。结果显示:①出生后即刻各HIE组血中NSE、ET-1水平随损伤程度不同而不同,损伤越重,血NSE、ET-1水平越高,且HIE组与对照组对比差异具有统计学意义(P<0.01);出生后3天,轻度组ET-1与对照组对比无明显差异(P>0.05),在轻、中、重三组中,中、重度ET-1水平均明显降低,但均比对照组水平高(P<0.01),且损伤愈重水平愈高;出生7天轻、中、重三组ET-1、NSE水平进一步降低,除轻度组NSE与对照组水平接近(P>0.05)外,中、重两组NSE水平均比对照组水平高(P<0.01)。②出生后即刻各观察组血中CGRP水平随损伤程度不同而变化,均明显低于对照组(P<0.01),损伤越重,CGRP水平越低;出生后3天,轻、中、重度三组CGRP水平均明显增高,轻度组与对照组无显著性差异(P>0.05),中度组明显高于对照组,差异具有统计学意义(P<0.01);重度组低于对照组、轻度组和中度组(P<0.01);出生7天轻度组水平无明显变化(P>0.05),中度组水平逐渐恢复,但仍高于对照组(P<0.01),重度组水平进一步升高并超过对照组(P<0.01)。结论:CGRP可作为一种神经损伤的信号,出生后即刻HIE新生儿血CGRP水平显著降低,病情越重降低越显著,随病情好转,各HIE组的CGRP水平均进一步升高,生后即刻HIE新生儿血ET-1、NSE水平显著升高,病情越重升高越显著,随病情好转,各HIE组的ET-1、NSE水平显著降低,提示CGRP对ET-1具有生物学拮抗作用,是内源性ET-1拮抗剂,能抑制ET-1的合成及释放;HIE患儿生后损伤越重,血NSE水平越高,而且随病情恢复进行性降低,提示NSE是神经元损伤程度的重要标志,对早期准确了解脑损伤有重要意义。
To detect the blood levels of endothelin（ET-1）,neuron-specific enolase（NSE） and calcitonin gene-related peptide（CGRP） of neonates with different grades of hypoxic-ischemic encephalopathy（HIE）,and to explore the clinical significance of serum ET-1,NSE and CGRP in the progress of HIE.The blood concentrations of ET-1,NSE and CGRP in 46 neonates with HIE and 15 control neonates at different birth time were detected by radioimmunoassay.The results showed that the blood levels of ET-1,NSE in neonates with HIE at birth were significantly higher than those in controls（P0.01）.The blood levels of ET-1 and NSE were increase as the worse degree of HIE increase.As the HIE improving,the blood levels of ET-1 and NSE significantly decreased.The concentrations of CGRP in experiment groups were significantly lower than that of control group at birth.The blood levels of CGRP were decrease as the worse degree of HIE increase.With the HIE improve,the concentrations of CGRP in experiment groups increased.The serum CGRP acting as a signal of impaired nerve,play a key role in the pathogenesis of neonate with HIE.NSE is an important sign of nervous impairment and ET-1 can reduce the flow of blood in brain and further strengthen the nervous impairment.CGRP can suppress the function of ET-1,and play a key role in preventing the progress of neonates with HIE.
出处
《标记免疫分析与临床》
CAS
2011年第1期28-32,共5页
Labeled Immunoassays and Clinical Medicine
