母胎血一氧化氮的测定及其临床意义

The detection and clinical significance of NO level in maternal and fetal blood

目的探讨一氧化氮（NO）对分娩时子宫收缩和胎儿-胎盘循环系统的影响及其意义。方法应用荧光分光光度法对明式分娩组25例，剖宫产组49例的母、胎血NO进行比较。结果剖宫产组的母血和脐血的NO值分别明显高于阴式分娩组（P＜0．05）。在剖宫产组中20例无宫缩剖宫产组的母血和脐血的NO值分别明显高于29例有宫缩剖宫产组（P＜0．01和P＜0．05）。在有宫缩剖宫产组中18例第一产程手术组的母血和脐血的NO值分别明显高于11例第二产程手术组（P＜0．01和P＜0．05）。新生儿窒息的脐血NO值明显低于无新生儿窒息者（P＜0．01）。结论NO的合成、释放减少对子宫平滑肌组织及血管产生收缩作用，可引起分娩发动，并对维持分娩发挥作用，但NO过度减少容易产生新生儿窒息。

Objective To investigate the effect of NO level on uterine contraction and fectoplacental circulation and its clinical significance. Methods Using fluorophotometry, we measured and compared the NO level of maternal and fetal blood from 25 cases of vaginal delivery and 49 cases of cesarean section(CS). Results NO level of maternal and umbilical blood in CS group was greatly higher than that of vaginal delivery group(P ＜ 0.05). In CS group, NO level in noncontractive CS group(20 cases) was significantly higher than that of contractive CS group(29 cases), (P ＜ 0.01, P ＜0.05),and in later group, NO level in first stage was significantly higher than that in Second stage(P ，＜ 0.01, P＜0.05). NO level in umbilical blood of asphyxiated infants was significantly higher than that in nonasphyxiated infants.Conclusion The decreased synthesis and release of NO play an important role in the smooth muscle contraction of uterine and blood vessel, and it can initiate and maintain labor. But great lowering of NO level may cause neonatal asphyxia.