剖宫产与阴道分娩产新生儿脐血胰岛功能检测结果分析

The Islet Function Examination of Umbilical Cord Blood of Newborn from Cesarean Section and Vaginal Delivery

目的探讨剖宫产与阴道分娩产新生儿胰岛功能的差异。方法随机选取剖宫产50例,阴道分娩产50例。孕期39～41周,新生儿体重、APgar评分无明显差别。检测两组胎儿脐血胰岛素(INS)、C肽(C-P)和胰岛素抗体(ANS),用流式细胞仪酶标法测定T淋巴细胞抗原(CD4、CD8)。结果剖宫产组女性婴儿脐血淋巴细胞CD4抗原、CD4与CD8混合抗原显著高于阴道分娩组(P<0.01),而CD8抗原却显著低于阴道分娩组(P<0.01);剖宫产女性婴儿脐血淋巴细胞CD4/CD8比值显著高于阴道分娩组(P<0.01);剖宫产组男性婴儿脐血淋巴细胞只有CD4与CD8混合抗原显著高于阴道分娩组(P<0.01);剖宫产组新生儿脐血胰岛素(INS)、C肽(C-P)明显低于阴道分娩产组(P<0.05),胰岛素抗体(ANS)两组均为阴性。结论剖宫产可能影响新生儿的胰岛功能,增加糖尿病的发生风险,而剖宫产导致的免疫功能异常可能在其中起主要作用。

Objective To explore the difference of neonatal islet function between the vaginal delivery and cesare- an section. Methods Either 50 cases cesarean section or 50 cases vaginal delivery were randomly selected. The time of pregnancy was 39 - 41 weeks. There were no obvious difference for birth weight and APgar score. The fetal umbilical cord insulin （INS）, C peptide （C-P） and insulin antibody （ANS） for two groups were deter- mined. The T lymphoeytes antigen （ CD4, CD8） was determined by Flow eytometrie enzyme standard method. Results The levels of CD4 antigens of umbilical cord blood lymphocytes of female baby from cesarean section and mixed antigen from CD4 and CD8 was significantly higher than that of in vaginal delivery group （P 〈 0.01 ）, but the CD8 antigen was significantly lower than that of vaginal delivery group （P 〈 0.01 ） ; the ratio of CD4/CD8 of umbilical cord blood lymphocytes of female baby from cesarean section was significantly higher than the vaginal delivery group （ P 〈 0.01 ） ; The level of CD4 and CD8 mixed antigen of umbilical cord blood lymphocytes of male baby from cesarean section was only significantly higher than a vaginal delivery group （ P 〈 0.01）. The levels of fetal umbilical cord blood insulin （INS） and C peptide （C-P） from cesarean sections were significantly lower than that of the vaginal delivery of production. The insulin antibodies （ANS） in two groups were negative. Conclusion The cesarean section of the fetus could affect the fetal islet function and increase the risk of diabetes, and the immune dysfunction resulted by cesarean section may play a major role in these process.