胡电，古航，洪新如，金志军，刘彦，侯庆香，曹立萍.高压氧对窒息新生儿血中孤啡肽含量的影响[J].中华物理医学与康复杂志,2004,(4):
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| 高压氧对窒息新生儿血中孤啡肽含量的影响 |
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| DOI： |
| 中文关键词: 新生儿窒息 孤啡肽 高压氧 |
| 英文关键词: Neonatal asphyxia Orphanin Hyperbaric oxygenation |
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| 中文摘要: |
| 目的观察窒息新生儿经高压氧（HBO）治疗后其血中孤啡肽含量的变化。 方法共选取新生儿77例，根据其在宫内有无窒息史，将33例正常新生儿归为对照组，剩下的44例宫内有窒息史的新生儿归为窒息组。同时根据治疗手段不同，将窒息组新生儿进一步分为2个亚组，窒息常规组（22例）及窒息HBO组（22例）。窒息常规组患儿接受常规处理，窒息HBO组在常规处理的基础上加用高压氧（HBO）治疗。用放射免疫法测定3组新生儿在治疗前、后其脐动脉血及静脉血中孤啡肽含量的变化。 结果（1）窒息组新生儿在分娩时的脐动脉血中孤啡肽含量为（27.53±7.04）ng/L，与对照组（12.52±3.05）ng/L比较，差异有显著性意义（P<0.01）；（2）窒息组新生儿脐动脉血血气分析结果：pH为(7.0±0.1)，氧分压为(1.6±0.8)kPa，CO2分压为 (8.9±0.7)kPa；其孤啡肽含量与脐动脉血pH、氧分压呈显著负相关，与CO2分压呈显著正相关；（3）窒息HBO组新生儿经高压氧治疗后，其静脉血孤啡肽含量显著降低，与对照组比较, 差异无显著性意义，而治疗后的窒息常规组新生儿其血中孤啡肽含量仍处于较高水平，与对照组和窒息HBO组比较，差异均有显著性意义；（4）窒息组新生儿血中孤啡肽含量与新生儿Apgar评分呈显著负相关。 结论孤啡肽参与了新生儿窒息的病理变化过程，与窒息的发生、发展密切相关；HBO能显著改善窒息新生儿的缺血、缺氧损伤，其机制可能与抑制孤啡肽的生成有关。 |
| 英文摘要: |
| Objective To investigate the effects of hyperbaric oxygenation therapy on the concentrations of serum orphanin(OFQ) in newborns with asphyxia. MethodsForty-four full-term newborns with asphyxia (asphyxia group) and 33 healthy neonates (control group) were recruited. In these asphyxia newborns, 22 subjects were performed HBO therapy, once a day for 10 days, the rest subjects were underwent conventional therapy. Concentration of plasma OFQ was measured by radioimmunoassay before the start of and at the end of the whole treatment program. Results(1)The concentrations of umbilical artery plasma OFQ in asphyxia+HBO group and control group were（27.53±7.04）ng/L and（12.52±3.05）ng/L, respectively. The difference was significant (P<0.01). (2)The results of umbilical artery blood gas analysis of asphyxia +HBO group were as follow：pH 7.0±0.1, pO2 1.6±0.8 kPa, pCO2 8.9±0.7 kPa. The concentrations of OFQ were negatively correlated with pH and pO2 in umbilical artery, and were the significantly correlated with pCO2(P<0.01).(3)The concentrations of OFQ in asphyxia+HBO group significantly decreased, and the difference between the asphyxia +HBO group and the control group was not significant. However, the concentrations of OFQ in asphyxia group, treated with conventional therapy, was still high. The differences between the asphyxia group and the control group as well as the asphyxia + HBO group were significant. (4)The concentrations of OFQ in newborns with asphyxia were significantly negatively correlated with Apgar scores. ConclusionThe plasma OFQ might be involved in the pathophysiological changes of neonatal asphyxia, and be closely related with the incidence and development of asphyxia, The mechanism of HBO alleviating injury of neonatal asphyxia might be related to the inhibition of the synthesis and secretion of OFQ. |
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