胎儿宫内窘迫孕妇静脉血及脐血孤啡肽的变化

Changes of Plasma Orphanin in Venous Blood and Cord Blood of Pregnant Women with Fetal Asphyxia

目的探讨宫内窘迫脐血孤啡肽(OFQ)的变化及其临床意义。方法采用放射免疫法测定30例正常妊娠妇女(对照组)及23例胎儿宫内窘迫孕妇(缺氧缺血组)静脉血及脐血OFQ的含量,同时行脐动脉血血气分析。结果1.缺氧缺血组脐血OFQ(23.46±6.72)ng/L,对照组为(13.29±4.14)ng/L,两组相比有显著差异(P<0.05)。2.脐动脉血血气分析,pH 为(7.00±0.15),p(O2)为(1.70±0.42)kPa,p(CO2)为(8.80±0.69)kPa;OFQ与脐血pH、p(O2)呈显著负相关(r= -0.418,-0.437 P均<0.05),与p(CO2)呈显著正相关(r=0.442 P<0.05)。3.缺氧缺血组及对照组母血浆OFQ含量分别为(9.23±3.01)ng/L及(8.57±2.83)ng/L,两组相比无显著差异(P>0.05).4.脐血OFQ含量与母血OFQ含量无显著相关(r=0.287 P>0.05)。结论OFQ与缺氧缺血导致的胎儿窘迫及新生儿窒息的发生发展密切相关。

Objective To evaluate the role of orphanin（OFQ） on hypoxia - ischemia newborns in pregnant women with fetal asphyxia. Methods Thirty pregnant women with fetal distress （hypoxia - ischemia group） and 23 healthy pregnant women（control group） in their third trimester were studied. The concentrations of plasma OFQ were measured by radioimmunoassay. Umbilical artery pH, p （O2） and p （CO2）were also measured. Results 1. The level of umbilical artery plasma OFQ in hypoxia - ischemia group was （23.46 ± 6.72 ） ng/L. In control group, the level of OFQ was （ 13.29 ±_ 4.14 ） ng/L, the level of umbilical artery plasma OFQ in fetal distress group was significantly higher than that in control group （P〈 0.05 ）. 2. The umbilical artery blo：xt gas analysis： pH was （7.00 ±0.15）,p（Oz） was （1.70±0.42） kPa, p（OD-z） was （8.80 ±0.69） kPa; The negatively correlation was found between the OFQ and p （（X）-z） （P 〈 0.05）. 3. The levels of maternal plasma OFQ in fetal distress group and control group were （9.23 ± 3.01 ） ng/L and （8.57 ± 2.83） ng/L respectively, there was no significant difference in the levels of maternal plasma OFQ between control group and hypoxia- ischemia group（P 〉0.05）. Conclusion Hypoxia - ischemia is associated with OFQ, the changes of OFQ levels in umbiliea artery plasma may play an important role in the pathophysiologieal changes in fetal distress and neonatal asphyxia.