不同复苏氧浓度对宫内窘迫胎鼠脑细胞内外钙的影响  

Cerebral intra-and extra-cellular calcium concentrations in asphyxiated rat fetuses resuscitated with oxygen of different concentrations

作　　者：农绍汉[1] 谢衍铭[1] 黄小穗[2] 

机构地区：[1]广东省人民医院新生儿科,广东广州510080 [2]广东省人民医院血液流变学室,广东广州510080

出　　处：《中国当代儿科杂志》2001年第4期363-366,共4页Chinese Journal of Contemporary Pediatrics

基　　金：广东省重点科技项目 (编号 :2KM 0 5 60 4S)

摘　　要：目的　探讨窒息时复苏氧浓度与复苏效果的关系 ,找出较佳复苏氧浓度 ,改善窒息新生儿预后。方法　将 5 6只胎龄为 2 0d的SD大鼠胎鼠随机分为 5组 ,即假手术组 (对照组 ) 11只 ,空气复苏组 (复苏组 ) 10只 ,给予不同浓度氧和在不同时间内复苏的Ox1组 14只 ,Ox2 组 11只和Ox3组 10只。监测各组胎鼠脑细胞内外钙、钠、钾含量的变化。结果　复苏组与Ox1组 (氧浓度 92 .8% )的脑细胞内游离钙离子浓度分别为 ( 5 5 2 .0 8± 93 .5 0 )nmol/L和 ( 5 2 0 .61± 79.0 8)nmol/L ,两者相近 (P >0 .0 5 ) ,但均明显高于对照组 ( 3 15 .2 7± 86.88)nmol/L(P <0 .0 1)。应用 65 %氧复苏时 ,在窒息缺氧前 (Ox2 组 )和在窒息缺氧的同时 (Ox3组 )复苏者 ,其脑细胞内游离钙离子浓度分别为 ( 4 41.4 6± 4 7.93 )nmol/L和 ( 4 5 2 .93± 3 6.3 8)nmol/L ,虽仍高于对照组 ,但明显低于空气复苏组 (P <0 .0 1)和Ox1组 (P <0 .0 5 )。各组脑组织总钙、钠、钾含量基本上差异无显著性 (P >0 .0 5 )。结论　不同氧浓度复苏 ,其效果不一样 :应用 92 .8%氧或空气复苏 ,其复苏效果相似 ,提示临床上可考虑应用空气代替纯氧对窒息新生儿进行复苏 ;采用 65 %氧复苏 ,其复苏效果可能较纯氧或空气复苏更佳。Objective To investigate the effects of resuscitation using oxygen of three concentrations on changes of cerebral intra-and extra-cellular calcium, sodium and potassium in asphyxiated fetal rats. Methods Fifty-six fetal rats of twenty-day gestational age were randomly divided into five groups: sham operation (control, n=11), room-air resuscitation (n=10), and oxygen-resuscitated group I, Ⅱ, Ⅲ (n=14, 11, and 10 respectively) of different oxygen-inhaled concentrations and different oxygen timings. The fetal rats in the latter four groups suffered from ischemia and hypoxia in-uteri resulting from interruption of placental circulation. After recirculation, intra- and extra-cellular concentrations of calcium, sodium, and potassium in the brains were measured in each group. Results Intracellular free calcium concentrations of fetal rat brains in the room-air resuscitation group and the oxygen-resuscitated group I (oxygen-inhaled concentration was 92.8%) were ( 552.08± 93.50) nmol/L and ( 520.61± 79.08) nmol/L respectively. They were similar and both significantly higher than those in the control ( 315.27± 86.88) nmol/L (P< 0.01). After resuscitation with 65% oxygen, no matter whether it started before (group Ⅱ) or at the beginning of hypoxia (group Ⅲ), their intracellular free calcium concentrations [( 441.46± 47.93) nmol/L and ( 452.93± 36.38) nmol/L respectively] were significantly lower than those in the room-air resuscitation group (P< 0.01) and group I (P< 0.05), though still higher than those in the control. There was generally no difference in the total concentrations of calcium, sodium, or potassium among all groups. Conclusion Resuscitation with oxygen of different concentrations produced different results: Resuscitation with 92.8% oxygen or room air had a similar effect on the parameters measured, indicating that resuscitation of asphyxiated neonates using pure oxygen might not be superior to that using room air; With lower cerebral intracellular calcium concentrations, resus

关 键 词：复苏氧浓度 钙 脑损害 宫内窘迫 

分 类 号：R722.12[医药卫生—儿科]