新生儿窒息时母脐血中炎症介质、一氧化氮及其合酶的变化

Changes TNF-α,IL-6,NO and NOS in Maternal and Umbilical Cord Blood with Asphyxia Neonatorum

目的观察新生儿窒息时母、脐血肿瘤坏死因子(TNF-α)、白介素-6(IL-6)、一氧化氮(NO)及其合酶(NOS)水平的变化。方法临产时出现急性胎儿窘迫的住院孕妇60例,其中出现新生儿窒息者为窒息组,娩出后胎儿正常者为窘迫组。选择正常足月孕妇30例为对照组。所有胎儿娩出后迅速进行1minApgar评分,作为新生儿窒息的判定标准;并检测脐血pH值。制备母血、脐血的血清标本,检测TNF-α、IL-6、NO含量及NOS活性。结果窒息组脐血pH显著低于其它两组。母血TNF-α、IL-6、NO、NOS水平在三组之间未见统计学差异;窒息组脐血TNF-α、IL-6、NO含量显著高于窘迫组和对照组,窒息组脐血NOS活性高于对照组,窘迫组的这些指标高于对照组。结论窒息新生儿脐血的TNF-α、IL-6、NO等炎症介质含量增多,为窒息新生儿的治疗提供了实验依据。

Objective To explore the changes of tumor necrosis factor-α （TNF-α）, interleukin-6 （ IL- 6）, nitric oxide （NO） and nitric oxide synthase （NOS） in maternal and umbilical cord blood with asphyxia neonatorum. Methods 60 cases subjected to acute fetal distress were divided into fetal distress group in which the neonatus is normal and asphyxia neonatorum group in which the neonatus has asphyxiation with 30 in each group. Thirty cases that pregnant woman and neonatus were both healthy serve as control. After childbirth, Apgar score of 1 minute is assessed and pH values of umbilical cord blood are measured quickly for the determination of neonatal asphyxia. And then the contents of TNF-α, IL-6 and NO and the activity of NOS are detected in the maternal and umbilical cord blood. Results There are no statistically significant differences in the levels of TNF-α, IL-6, NO and NOS of maternal blood among three groups. The pH in asphyxia neonatorum group was lower than that in other two groups. The levels of TNF-α, IL-6 and NO in umbilical cord blood of asphyxia neonatornm group were increased obviously compared with those of fetal distress group and control group, the activity of NOS in asphyxia neonatornm group was increased obviously than that of control group, and those indexes of fetal distress group are markedly higher than those in control group. Conclusion The inflammation mediators such as TNF-α, IL-6 and NO were increased in umbilical cord blood of asphyxia neonatorum, and that provides experiment basis for the treatment of asphyxia neonatornm.