摘要
目的了解胎粪吸入综合征(MAS)患儿支气管肺泡灌洗液(BALF)及血中一氧化氮(NO)和内皮素(ET1)浓度的变化,探讨MAS患儿肺部损害的发病机制。方法MAS患儿60例随机分为A、B两组。A组29例,为Ⅱ型呼衰需呼吸机辅助呼吸者;B组31例,为轻度胎粪吸入性肺炎患儿;C组32例,为健康新生儿对照组。3组均于生后1、3、5、10d取静脉血,A组于生后1、3d、撤机前取BALF。NO测定应用硝酸盐还原法,ET1应用放射免疫法。结果MAS患儿初期血中NO浓度降低,ET1浓度升高,随着病程进展重度MAS患儿出现NO的异常增高,而ET1降至正常以下。BALF中NO浓度随病程进展逐渐升高,ET1浓度逐渐降低。结论NO降低、ET1升高可能参与MAS早期肺部病理生理变化,导致肺血管过度收缩使肺动脉压力升高,而后期内源性NO产生异常增加,可能参与重度MAS患儿后期的持续的肺部炎症反应及肺损害。
Objective To explore the changes of nitric oxide（NO） and endothelin 1 （ET- 1 ） in bronchoalveolar lavage fluid （BALF） and vein blood of newborn infants with meconium aspiration syndrome（MAS）, and the machanism of hmg damage in MAS patients. Methods There were 29 MAS patients in group A with type Ⅱ acute respiratory failure who were requiring mechanical ventilation. There were 31 mild MAS cases who didn＇t need mechanical ventilation in group B. Group C included 32 healthy newborns. Blood samples had been taken in 4 times（corresponding to equal toor less than ldays, 3 days, 5 days and 10 days after birth）. Bronchoalveolar lavage was performed at group A at the 1 day, the 3 day and before stopping the mechanical ventilation. Nitriate recovery and radio- immunity were used to determine NO and ET- 1 concentraticxa. Results During the earily period of MAS patients, NO was increased and ET- 1 decreased, during the following period, NO was endogenously produced. NO in BALF was increased ,and ET- 1 was decreased following the disease progres. Conclusions During the earily period of MAS, low NO and high ET - 1 may be associated with the hypoxemic and pulmonary hypertension. During the following period, high NO is likely to react with the ongoing pulmonary inflarranation and the chronic lung dsease.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2005年第12期1225-1227,共3页
Journal of Applied Clinical Pediatrics
关键词
婴儿
新生
胎粪吸入综合征
支气管肺泡灌洗液
一氧化氮
内皮素
infant, newborn
meconium aspiration syndrome
bronchoalveolar lavage fluid
nitric oxide
endothelin - 1
