早产儿脐血激活素A水平检测的临床意义

Measurement of umbilical activin A level in preterm infants

目的探讨早产儿脐血血清激活素A检测的临床意义。方法将41例胎龄为28～36周的早产儿作为研究对象,分别留取脐带、脐血和胎膜,用ELISA方法检测脐血血清激活素A的水平,镜下观察胎膜及脐带的病理改变。结果 41例早产儿脐血血清激活素A平均水平为2069 pg/mL。5例宫内感染的患儿脐血血清激活素A水平明显高于无感染患儿(2510 pg/mL vs 1975 pg/mL,P<0.01)。脐血血清激活素A对宫内感染的诊断临界值为2490 pg/mL,敏感度为80.0%,特异度为90.6%。脐血血清激活素A的水平与生后是否发生呼吸窘迫综合征无关,但与生后氧疗时间存在正相关关系(r=0.326,P<0.05)。结论脐血激活素A可作为反映早产儿宫内感染的指标,其水平高低与生后氧疗时间有关。

Objective To evaluate the clinical significance of umbilical activin A in preterm infants.Methods Forty-one preterm infants（gestation 28 to 36 weeks） were enrolled.Fetal membranes,umbilical cords and blood samples from umbilical vein were obtained.Umbilical activin A level was measured using ELISA.The histological examinations of fetal membranes and umbilical cords were performed.Results The umbilical level of activin A averaged 2069 pg/mL in the 41 preterm infants.The umbilical activin A level in the 5 infants with intrauterine infection was higher than in those without intrauterine infection（2510 pg/mL vs 1975 pg/mL;P0.01）.Umbilical activin A level at cutoff of 2490 pg/mL showed a sensitivity of 80.0% and a specificity of 90.6% as a marker of intrauterine infection.There were no significant differences in the umbilical activin A level between the infants with and without respiratory distress syndrome.Umbilical activin A level was positively correlated with the duration of postnatal oxygen therapy（r=0.326,P0.05）.Conclusions Umbilical activin A may serve a marker of intrauterine infection in preterm infants.The umbilical activin A level is correlated with the duration of postnatal oxygen therapy.