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为了解胎儿窘迫时孕妇血及脐血中一氧化氮 (NO)水平的变化及其与胎儿窘迫及新生儿窒息的关系。对 42例胎儿窘迫孕妇 (胎儿窘迫组 )及 36例正常晚孕妇女 (对照组 )母血、脐血中 NO代谢产物亚硝酸 /硝酸基 (NO- 2 / NO- 3 )进行测定 ;以血气分析仪测定脐血 p H值。结果显示 胎儿窘迫组母血及脐血 NO水平均较对照组明显下降 (P均 <0 .0 1 ) ,胎儿窘迫组与对照组相比 :脐血 p H下降 (P<0 .0 1 ) ;新生儿Apgar评分下降 (P<0 .0 1 ) ;新生儿一分钟 Apgar评分≤ 7分的例数所占比例上升(P<0 .0 1 )。母血 NO≤ 2 .6 6 umol/ L,脐血 NO≤ 2 .0 3umol/ L时新生儿窒息率明显上升 (P<0 .0 1 ) ,与脐血 p H值 <7.2 0时相比 ,两者新生儿窒息率无显著差异 (P>0 .0 5 )。新生儿脐血 p H值与脐血 NO水平呈高度正相关 (r=0 .74,P<0 .0 1 )。结论 母血及脐血 NO下降与胎儿窘迫有一定关系 ;NO水平下降在预测新生儿窒息时与脐血 p H值有同等价值 ;监测母血及脐血 NO水平可作为诊断胎儿窘迫的指标之一。指导临床及时处理胎儿窘迫 ,为减少新生儿窒息的发生起很重要的作用。
To understand the changes of the level of nitric oxide (NO) in maternal blood and umbilical cord blood during fetal distress and its relationship with fetal distress and neonatal asphyxia. The NO metabolites nitrite / nitric acid (NO-2 / NO-3) in 42 cases of fetal distress in pregnant women (fetal distress group) and 36 normal pregnant women (control group) Analyzer measured umbilical cord blood p H value. The results showed that the level of NO in fetal distress group was significantly lower than that in control group (P <0.01). Compared with control group, fetal distress group had lower p H (P <0.01) ; Neonatal Apgar score decreased (P <0.01); Neonatal Apgar score ≤ 7 points increased the proportion of cases (P <0.01). Neonatal asphyxia increased significantly (P <0.01) when umbilical cord blood NO≤2. 6 6 umol / L and umbilical cord blood NO≤2. 3umol / L, There was no significant difference in neonatal asphyxia between the two groups (P> 0.05). The neonatal umbilical blood p H value and umbilical cord blood NO levels were highly positive (r = 0.74, P <0.01). Conclusions The decrease of NO in maternal blood and umbilical blood is related to fetal distress. The decrease of NO level has the same value as the p H value of umbilical cord blood in predicting neonatal asphyxia. Monitoring the level of NO in maternal blood and cord blood can be used as an index to diagnose fetal distress one. To guide clinical timely treatment of fetal distress, in order to reduce the incidence of neonatal asphyxia play a very important role.