论文部分内容阅读
目的探讨胎儿宫内生长受限(FGR)胎儿个体在胎儿和早期新生儿期循环中脑和脂肪组织炎症标志物变化与胎儿宫内不良发育的相关性。方法 2009年7月至2010年7月中国医科大学附属盛京医院分娩的30例足月单胎FGR新生儿为FGR组,30例足月单胎适于胎龄儿(AGA)为AGA组,分别采集脐静脉血和出生后第1天和第4天静脉血,采用酶联免疫分析法测定血浆炎症标志物超敏CRP(hs-CRP)、纤溶酶原激活物抵制剂1(PAI-1)、S100B及瘦素浓度。结果 FGR组新生儿平均体重、身长及体重指数(BMI)均低于AGA组(P均<0.05)。AGA组与FGR组比较,脐血瘦素水平明显降低(P<0.05),且脐血瘦素水平与新生儿体重和BMI明显正相关(P均<0.05)。两组新生儿脐血和出生后血浆hs-CRP差异均无统计学意义(P均>0.05)。组内比较,两组新生儿脐血和出生后第4天血浆hs-CRP浓度均明显低于出生后第1天(P均<0.05)。AGA组与FGR组比较,血浆PAI-1和S100B在3个时间点差异均无统计学意义(P均>0.05)。脐血PAI-1和S100B浓度与新生儿体重和BMI均无相关性(P均>0.05)。结论 FGR早期新生儿体重和BMI及脐血瘦素水平降低,但血循环中炎症标志物hs-CRP和PAI-1水平与AGA新生儿差异无统计学意义。从胎儿到生后早期不同阶段体循环中CRP变化可揭示分娩应激反应引起的机体CRP升高到恢复过程。
Objective To investigate the correlation between changes of inflammatory markers in brain and adipose tissue and fetal intrauterine growth during fetal and early neonatal period in fetus with fetal growth restriction (FGR). Methods From July 2009 to July 2010, 30 infants with full-term single-child FGR delivered by Shengjing Hospital affiliated to China Medical University were selected as FGR group, 30 full-term single-litter suitable for AGA group as AGA group, Umbilical vein blood and venous blood on day 1 and day 4 postnatal day were collected respectively. Serum inflammatory markers such as hs-CRP, PAI- 1), S100B and leptin concentration. Results The average body weight, body length and body mass index (BMI) of neonates in FGR group were lower than those in AGA group (all P <0.05). Cord blood leptin level was significantly lower in AGA group than in FGR group (P <0.05), and cord blood leptin level was positively correlated with newborn body weight and BMI (all P <0.05). There was no significant difference in plasma hs-CRP level between neonatal umbilical cord blood and postnatal group (P> 0.05). The intrauterine blood pressure and plasma hs-CRP concentrations in both groups were significantly lower than those on the first day after birth (all P <0.05). Compared with FGR group, there was no significant difference in plasma PAI-1 and S100B between AGA group and FGR group at 3 time points (all P> 0.05). Cord blood PAI-1 and S100B concentration and neonatal body weight and BMI had no correlation (P all> 0.05). Conclusions The body weight, BMI and cord blood leptin levels in early neonatal FGR are decreased. However, the levels of hs-CRP and PAI-1, the markers of inflammation in blood circulation, are not significantly different from those of neonatal AGA. The changes of CRP in the systemic circulation from different stages of fetus to early stage of pregnancy can reveal the body’s CRP increased to the recovery process due to labor stress response.