不同分娩方式产妇产后血清催乳素水平、自评泌乳量及初乳中生长因子浓度

The level of serum prolactin,self-estimated milk yield and growth factor level in colostrum of pregnant women adopting different delivery modes

目的:比较自然分娩与剖宫产产妇产后2～5天自评泌乳量、产后6～24h血清中催乳素(PRL)以及初乳中胰岛素样生长因子-1(IGF-1)、表皮生长因子(EGF)浓度的差异。方法:在医院产科对招募的志愿者收集产后6～24h的血清及产后2～5天的初乳。采用化学发光免疫分析法测定自然分娩组与剖宫产组PRL的含量,采用生物素-亲和素酶联免疫吸附试验测定两组初乳中IGF-1和EGF的浓度。结果:自然分娩组产后血清PRL浓度为(361.67±80.74)ng/ml,剖宫产组为(221.94±90.82)ng/ml,两组之间差异有统计学意义(P<0.05)。产后2～3天,剖宫产组初乳中IGF-1浓度高于自然分娩组(P<0.05),而自评泌乳量低于自然分娩组(P<0.05)。产后4～5天,两组IGF-1浓度及自评泌乳量差异无统计学意义(P>0.05)。产后2～5天,剖宫产组EGF浓度略高于自然分娩组,但两组差异无统计学意义(P>0.05)。结论:剖宫产组产妇早期初乳中较高的IGF-1以及血清中较低的PRL水平与泌乳延迟和泌乳量相关,建议剖宫产后产妇仍应坚持早接触、早吸吮,提倡早期母乳喂养。

Objective ： To compare differences of serum prolactin level, self - estimated milk yield during 2 - 5 days after delivery and levels of insulin - like growth factor - 1 （ IGF - 1 ）, epidermal growth factor （EGF） during 6 - 24 hours after delivery in colostrum of pregnant women adopting spontaneous labor and cesarean section. Methods： The serum samples during 6 - 24 hours after delivery and colos-trum samples during 2 - 5 days after delivery were collected, the levels of prolactin in spontaneous labor group and cesarean section group were .detected by chemiluminescent immunoassay, the serum levels of IGF - 1 and EGF in spontaneous labor group and cesareansection group were detected by biotin - avidin enzyme - linked immunosorbent assay. Results： There was significant difference in serum prolactin level between spontaneous labor group [ （361.67 ＋ 80. 74） ng/ml] and cesarean section group [ （221.94 ＋ 90. 82） ng/ml]（P 〈 0. 05 ） . During 2 - 3 days after delivery, the level of IGF - 1 in cesarean section group was significantly higher than that in spontaneous labor group （ P 〈 0. 05 ）, the level of self - estimated milk yield in cesarean section group was significantly lower than that in spontaneous la- bor group （ P 〈 0. 05 ） . During 4 - 5 days after delivery, there was no significant difference in serum IGF - 1 level and self - estimated milk yield between the two groups （ P 〉 0.05 ） . During 2 - 5 days after delivery, the level of EGF in cesarean section group was higher than that in spontaneous labor group, but there was no significant difference （ P 〉 0. 05 ） . Conclusion： The high level of IGF - 1 and low level of prolactin in colostrums of cesarean section group are related to lactation delay and milk yield, early contact, early sucking and breast feeding are advocated for pregnant women adopting cesarean section.