新生儿缺氧缺血性脑病红细胞胞浆游离钙及脑血流动力学变化的临床意义  

Changes of RBC [Ca^(2+)] i levels and cerebral hemodynamics indices in neonates with hypoxic-ischemic encephalopathy and its clinical significance

作　　者：周秀芳[1] 金敏[1] 

机构地区：[1]甘肃省兰州市妇幼保健院新生儿科,730030

出　　处：《中国妇幼保健》2010年第11期1539-1541,共3页Maternal and Child Health Care of China

基　　金：兰州市科技发展计划项目〔项目编号:01-1-63〕

摘　　要：目的:探讨新生儿缺氧缺血性脑病(HIE)对红细胞胞浆游离钙(RBC[Ca2+]i)水平及脑血流动力学的影响及意义。方法:HIE组30例,正常对照组20例。HIE患儿于生后24h内采集静脉血2ml,采用Fura-2/AM法检测RBC[Ca2+]i水平;应用经颅彩色多普勒超声仪监测脑血流动力学参数,包括大脑中动脉收缩期峰值流速(PSFV)、舒张末期血流速度(EDFV)、平均血流速度(Vm)、阻力指数(RI)。并与正常对照组进行对比。结果:①HIE患儿RBC[Ca2+]i水平显著高于正常对照组[(2.68±0.05)vs(2.15±0.18);(2.80±0.17)vs(2.15±0.18),P<0.01]。HIE程度与患儿体内RBC[Ca2+]i水平具有相关性(r=0.453,P<0.05)。②HIE患儿PSFV、EDFV及Vm均低于正常对照组(P<0.01);RI高于正常对照组(P<0.01),存在明显的脑血流动力学紊乱,血流速度减慢,阻力指数增大。结论:RBC[Ca2+]i参与了HIE的病理生理过程,在HIE发病机制中可能起重要作用。监测RBC[Ca2+]i水平和脑血流动力学变化可能有助于HIE的早期诊断和预后判断,并指导临床治疗。Objective： To study change and its clinical significance of RBC [Ca^2＋]i levels as well as its role in regulating cerebral hemodynamics indices in neonates with hypoxic -ischemic encephalopathy （HIE） . Methods： The levels of RBC [Ca^2＋]i in the peripheral blood on the first day after birth in 30 term neonates with HIE and 20 healthy controls were measured using by Fura - 2/AM [ Fura -2 pentakis （acetoxymethyl） ester] . On the first day of life, the blood samples were colleted immediately when ultrasound examinations were finish. The ultrasound transducer was placed on the temporal fontanels to detect the hemodynamic parameters of the middle cerebral artery, including peak systolic flow velocity （PSFV） , end -diastolic flow velocity （EDFV）, mean blood flow velocity （Vm） and resistance index （RI） in both groups were measured by color Doppler ultrasound in the first day after birth. Results ： （1）The levels of RBC [Ca^2＋]i in neonates with HIE were significantly higher than those in normal control group [ （2. 68 ±0. 05） vs （2. 15±0. 18） , （2. 80 ±0. 17） vs （2. 15 ±0. 18）, respectively P 〈0. 01 ] . Correlation analysis showed that in neonates with HIE, RBC [Ca^2＋]i levels correlated positively with the severity of HIE Jr=0. 453, P〈0. 05] . （2）PSFV, EDFV and Vm of HIE patients were significantly lower than those in normal control group （ P 〈 0. 01 ） . RI of HIE patients were significantly higher than those in normal control group （ P 〈 0. 01 ） . There were remarkable cerebral hemodynamics disorders in neonates with HIE, lowered blood flow velocity and increased resistance index. Conclusion： RBC[Ca^2＋]i levels are closely associated with pathophysiological process of HIE, and may play an important role in the pathogenesis of HIE. Evaluating RBC [Ca^2＋]ilevels and cerebral hemodynamics indices in neonate ＇after birth may be helpful to monitor the early diagnosis, severity and prognosis of HIE and guide the clinical therapy of HIE.

关 键 词：缺氧缺血性脑病 红细胞胞浆游离钙 脑血流动力学 

分 类 号：R722.1[医药卫生—儿科]