中国当代儿科杂志
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CN 43-1301/R
 
中国当代儿科杂志
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新生儿呼吸衰竭时内源性一氧化氮及内皮素的动态观察
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摘要 目的 了解新生儿呼吸衰竭时内源性一氧化氮(NO) 和内皮素(ET) 的动态变化及其在新生儿呼衰的发病中所起的作用。方法 测定了38 例新生儿呼衰患儿的尿NO代谢产物亚硝酸和硝酸根离子(NO2 - + NO3 - = NOx) 和血浆ET 水平,同时监测患儿的动态肺顺应性和计算氧合指数(OI) 。结果 呼吸衰竭的患儿尿NOx (264.98±218.32 μmol/mg Cr) 水平明显降低,血浆ET(73 .01 ±10.06 ng/L)水平明显升高,其中的RDS组(208 .64 ±88.53 μmol/mg Cr,82.36 ±17 .83 ng/L) 变化最为明显。对照组尿NOx 和血浆ET 水平分别为397 .26 ±206 .61 μmol/mg Cr,40 .66 ±16.86 ng/L。随着疾病的恢复,存活者尿NOx 水平上升,而血ET水平下降,逐渐恢复正常。相关性分析显示尿NOx 与OI呈负相关,与肺顺应性呈正相关,而血ET与OI呈正相关,与肺顺应性呈负相关。结论 肺部疾病越重,尿NOx 水平越低,血ET水平越高;严重缺氧所致的内源性NO合成不足和ET 合成增加在新生儿呼吸衰竭的发生中可能起了重要的作用。
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Abstract:Objective To test intrinsic nitric oxide (NO) and endothelin (ET) activities in newborns with respiratory failure. Methods NO oxidation products (NO 2 -+NO 3 =NOx) and creatinine (Cr) were measured daily in the urine of 38 newborns with mechanical ventilation due to respiratory failure. NOx excretion was expressed by urine Cr excretion. Plasma ET was also tested in the patients. Lung compliance was monitored and oxygenation index (OI) was calculated in series. Results Five of the 38 patients developed respiratory distress syndrome. In these patients, urinary NOx (208.64±88.53 μmol/mg Cr) was extremely low while plasma ET was markedly high (82.36±17.83 ng/L). The average value of NOx (264.98±218.32 μmol/mg Cr) was significantly lower while plasma ET (73.01±10.06 ng/L) was higher in all the patients than those seen in the control newborns without pulmonary disease (397.26±206.61 μmol/mg Cr and 40.66±16.86 ng/L). Urinary NOx and plasma ET returned to the normal levels when the patients recovered from respiratory failure. In addition, the lower urinary NOx with the elevated plasma ET was related to the increased OI and to the reduced Lung Compliance. Conclusions Newborn patients with more severe respiratory failure have a lower level of urinary NO oxidation products and a higher level of plasma ET. The results suggest that the decrease of intrinsic NO production and the increase of ET induced by severe hypoxemia may play an important role in the pathogenesis of respiratory failure.
    
引用本文:   
. 新生儿呼吸衰竭时内源性一氧化氮及内皮素的动态观察[J]. 中国当代儿科杂志, 1999, 1(5): 0-0.
. [J]. CJCP, 1999, 1(5): 0-0.
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