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目的 研究不同妊娠、分娩因素对脐血β内啡肽 (β-EP)水平的影响。 方法 收集不同孕期的新生儿脐血共95例,用放射免疫法测定其β-EP水平,以β EP为因变量,以新生儿胎龄、性别、出生体重、分娩方式、母患高血压、母患糖尿病、宫内窘迫、胎膜早破为自变量,进行多元线性逐步回归,筛选出可能的影响因素,进一步研究不同影响因素时脐血β-EP变化。 结果 胎龄、分娩方式、宫内窘迫是影响脐血β-EP水平的重要因素(P均<0.05)。早产儿组脐血β EP值高于足月儿组,分别为(409.5±150.1)pg/ml、(261.4±141.5)pg/ml,差异均有统计学意义(P均<0.05)。阴道分娩组及产钳助产组高于选择性剖宫产组,差异有统计学意义(P均<0.05)。阴道分娩组与产钳助产组比较,差异无统计学意义(P均>0.05)。宫内窘迫组高于无宫内窘迫组,差异有统计学意义(P均<0.01)。 结论 分娩应激、疼痛会使β-EP升高,缺氧是影响β-EP水平的一个重要因素,脐血β-EP水平可作为胎儿缺氧的一个指标。早产儿脐血β EP高于足月儿是否是早产儿易发生呼吸暂停的病理生理基础,有待进一步研究。
Objective To study the effects of different pregnancy and childbirth factors on the level of β-endorphin (β-EP) in umbilical cord blood. Methods Ninety-five newborn umbilical blood samples were collected from different stages of pregnancy. The level of β-EP was determined by radioimmunoassay. The β EP was used as the dependent variable to estimate the gestational age, gender, birth weight, mode of delivery, Maternal diabetes, intrauterine distress, premature rupture of membranes as independent variables, multiple linear stepwise regression, screening out the possible influencing factors, to further study the different factors of umbilical cord blood β-EP changes. Results gestational age, mode of delivery, intrauterine distress is an important factor affecting umbilical blood β-EP levels (P all <0.05). The β EP of cord blood in preterm infants was higher than that in term infants (409.5 ± 150.1) pg / ml and (261.4 ± 141.5) pg / ml, respectively (all P <0.05). Vaginal delivery group and forceps midwifery group than the selective cesarean section group, the difference was statistically significant (P all <0.05). Vaginal delivery group and forceps midwifery group, the difference was not statistically significant (P all> 0.05). The intrauterine distress group was higher than the group without intrauterine distress, the difference was statistically significant (all P <0.01). Conclusion Labor stress and pain can increase β-EP. Hypoxia is an important factor affecting the level of β-EP. Cord blood β-EP level can be used as an indicator of fetal hypoxia. Preterm infants umbilical cord blood β EP is higher than full-term children is premature children prone to apnea pathophysiology, pending further study.