摘要
目的 研究新生儿呼吸窘迫综合征 (RDS)肺动脉压力动态变化及其与血清内皮素 1(endothelin 1,ET 1)、一氧化氮 (nitricoxide ,NO )的关系。方法 对 13例确诊为新生儿RDS患儿 (实验组 )和 2 0例正常新生儿 (对照组 )用脉冲超声多谱勒分别于生后 2、12、2 4、4 8、72h测定肺动脉血流加速时间 (TPV)及右心室射血时间 (RVET) ,以TPV/RVET比值反映肺动脉压力。用硝酸还原酶法和放射免疫法分别测定实验组和对照组新生儿生后 2 4、72h血清ET 1和NO的水平。结果 实验组和对照组新生儿肺动脉压力在生后 2、12及 72h差异无显著意义 (t值分别为 1 2 5、1 84、0 94 ,P均 >0 0 5 ) ;实验组 2 4、4 8hTPV/RVET比值为 0 2 77± 0 0 76、0 2 78± 0 0 2 7,对照组分别为 0 32 1± 0 0 5 1、0 32 9± 0 0 6 2 ,两组相比差异有显著意义 (t值分别为 2 86、2 2 0 ,P <0 0 1、 <0 0 5 ) ;实验组和对照组在生后 2 4h时ET 1[(6 2± 2 3)ng/L、(47± 8)ng/L]、NO[(11± 10 ) μmol/L、(32± 2 2 ) μmol/L]水平相比 ,差异有显著意义 (t值分别为 2 33、2 37,P均 <0 0 5 ) ;而 72h时差异无显著意义 (t值分别为 0 87、1 93,P均 >0 0 5 ) ,与肺动脉压力变化相一致。死亡组肺动脉压力 (0 2 5± 0 0 2 )
Objective To study the dynamic variation of pulmonary arterial pressures in infants with the neonatal respiratory distress syndrome (RDS), and its relationship with serum endothelin 1 (ET 1) and nitric oxide (NO) levels Methods (1) The ratios of time to peak velocity (TPV) over right ventricular ejection time (RVET) of 13 newborn infants with RDS (experimental group) and 20 normal newborn infants (control group) were examined with the echocardiography on the time of 2, 12, 24, 48 and 72 hours after birth The ratio of TPV/RVET was used to reflect the pulmonary artery pressure (2) Nitric acid reductase and radioimmunoassay were respectively used to measure the concentrations of serum ET 1 and NO at the time points of 24 and 72 hours after birth Results (1) There was no significant difference in TPV/RVET between experimental and control groups at the time of 2, 12 and 72 h after birth( t =1 25, 1 84 and 0 94, P >0 05) While the TPV/RVET was significantly different at the time of 24 and 48 h after birth ( t =2 86 and 2 20, P <0 01 and <0 05, respectively);(2) The concentrations of ET 1 and NO showed significant difference between the experimental group and control group at the time of 24 h after birth ( t =2 33, P <0 05 and t =2 37, P <0 05, respectively), while there was no significant difference at the time of 72 h after birth ( t =0 87, P >0 05 and, t =1 93, P >0 05, respectively);(3)The TPV/RVET and serum ET 1 levels of the dead group were significantly higher than those of the survived group ( t =2 35, P <0 05 and t =4 97, P <0 01, respectively), but NO levels were lower in the dead group than in the survived group ( t =2 38, P <0 05).(4)The serum ET 1 levels of experimental group at the time of 24 h after birth showed positive correlation with the pulmonary artery pressure: r =-0 66( P <0 05), y = 302 3 x -861 2,while the serum NO levels showed negative correlation to the pulmonary artery pressure: r =0 68 ( P <0 05), y =-98 3 x +400 8 Conclusions The newborn infants with RDS showed higher pulmonary pressure than the normal control and the higher pulmonary pressure lasted longer and easily complicated with persistent pulmonary hypertension leading to the death The study also revealed positive correlation between ET 1 levels and the pulmonary artery pressure, and negative correlation between NO levels and the pulmonary artery pressure
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2001年第11期678-681,共4页
Chinese Journal of Pediatrics
