产前应用糖皮质激素对早产儿体液S100B蛋白影响的观察

Maternal Glucocorticoid Administration and Change of S100B Protein Concentrations in Preterm Infants

目的观察脑损伤引起早产儿的血、尿S100B蛋白变化及糖皮质激素(GC)改善胎儿脑损伤效果。方法研究分2组:GC组:妊娠(34±1.38)周并在7d内有早产危险或因合并症需要提前终止妊娠的孕妇,产前使用糖皮质激素激素(GC)促胎儿成熟:地塞米松5mg肌内注射,12h 1次,共4次。新生儿出生后采集脐血、尿液样品,采用酶联免疫吸附法(ELISA)测定S100B蛋白含量。对照组:妊娠(34±1.26)周急诊入院早产未给地塞米松治疗即分娩的孕妇,同样采集脐血、尿液,测定S100B蛋白含量。二组新生儿行颅脑超声、Apgar评分等,研究结果采用PEMS3.1统计软件分析。结果 GC治疗组新生儿脐血、尿液S100B蛋白水平明显低于对照组,降低脑损伤胎儿出生S100B蛋白水平。结论 S100B蛋白作为胎儿围生期神经损伤的早期重要诊断和预后判定的重要指标,并对糖皮质激素激素对促早产儿成熟情况给以量化评价。

Objective To probe into the change of cord blood and urine S100B oncentration in preterm infants and to observe maternal glucocorticoid（GC） administration improving brain damage effects. Methods The study was divided into two groups. GC Group： pregnant women in （34±1.38） gestational weeks who were with the risk of premature delivery or complications have to premature termination of pregnancy, administration of Dexamethasone 5mg intramuscular injection（im.） every 12h per day in two days. Control Group： Pregnant women in （34±1.26） gestational weeks spontaneous delivery from emergency without giving Dexamethasone. In both groups, the infants routine laboratory ariables, neurologic outcome at 7-day follow-up, ultrasound imaging, and urine concentrations of S100B protein were determined at 6 time points. Urine S100B levels were measured by an immunoluminometric assay at first urination, 24, 48, 72, 96,120 hours, and 7 days after birth. Routine laboratory parameters and neurologic patterns were assessed at the same time as urine sampling. Results S100B protein was significantly higher at all of the monitoring time points in cord blood serum and urine taken from control infants than those of in GC group. Conclusions Antenatal GC administration can relieve the preterm infants brain damage while the use of S 100B as a tool to assess the effects of antenatal drug treatment.