妊娠期糖尿病母亲新生儿早期免疫球蛋白及补体测定

Immunoglobulin and complement among infants of gestational diabetic mothers： clinical significance of early detec-tion

目的测定新生儿早期免疫球蛋白和补体的血清含量，探讨妊娠期糖尿病母亲新生儿的早期免疫功能状况。方法测查并比较45例妊娠期糖尿病（GDM）孕妇分娩新生儿（GDM组），36例健康孕妇分娩的巨大儿（巨大儿组）及40例足月分娩正常体质量新生儿（对照组）12h内空腹静脉血清中免疫球蛋白IgG、IgA、IgM，及补体c3、c4的含量。结果新生儿血清IgG、IgA、IgM、C3和C4水平，GDM组分别为（7．41±1.21）g／L、（0．49±0．18）g／L、（0．30±0．11）g/L、（0．85±0．26）∥L和（0．58±0．64）g／L、巨大儿组分别为（9．60±1．46）g／L和（1．02±0．20）异／L、（0．31±0．12）g／L、（1．11±0．17）g／L和（0．82±0．45）g／L，对照组分别为（9．76±1．31）∥L和（0．98±0．22）∥L、（0．27±0．10）g／L、（1．09±0．19）∥L和（0．79±0．35）∥L，GDM组IgG、IgA、C5和C4水平低于巨大儿组和对照组，差异有统计学意义；3组血清IgM含量比较，差异无统计学意义。结论妊娠期糖尿病母亲分娩新生儿免疫水平较低、存在感染风险，需要加强监护、防治感染。

Objective To assess immune function by detecting immunoglobulin and complement among early neo- nates of mothers with gestational diabetes mellitus. Methods 45 newborns of mothers diagnosed as gestational diabetes were selected as the GDM group, 36 newborns with macrosomia group as the macrosomia group, and 40 full-term newborns as the control group. 3 ml of blood was collected in 12 hours after delivery. IgG, IgA, IgM, C3, and C4 were measured. Results Serum levels of IgG and IgA in the GDM group [ （7. 41 ± 1.21 ）g/L, （0. 49 ±0. 18）g/L） ] were lower than the macro- somia group [ （ 9. 60 ± 1.46 ） g/L, （ 1.02 ±0. 20） g/L ], and the control group [ （ 9. 76 ±1.31 ） g/L, （ 0. 98 ± 0. 22 ） g/L ]. IgG and IgA showed no significant difference between the macrosomia group and the control group. No statistically signifi- cant difference was observed among the three groups for serum IgM （0.30 ±0. ll）g/L,（0.27±0. 10） g/L, and （0.31 ± 0. 12） g/L, respectively. Serum levels of C3 and C4 in the GDM group [ （0. 85± 0.26 ） g/L, （ 0. 58 ± 0. 64 ） g/L 1 were lower than the macrosomia group [ （ 1.11 ± 0. 17 ） g/L, （ 0. 82 ± 0. 43 ） g/L] and the control group [ （ 1.09 ± 0. 19） g/L, （0. 79±0. 35）g/L]. C3 and CA showed no significant difference between the macrosomia group and the control group. Conclusion Low immunological status in newborns of diabetic mothers is indicated and thus the risk of infection is in- creased. This suggests the need to strengthen monitoring and control of infection among newborns of diabetic mothers.