母血HIF-1α水平联合胎心监护预测胎儿窘迫的价值

The Clinical Value of HIF-1α Levels in Maternal Blood and Fetal Heart Rate Monitoring for Fetal Distress

目的探讨母血中缺氧诱导因子-1α(HIF-1α)水平及联合胎心监护预测胎儿窘迫的价值。方法选取40名正常妊娠孕妇(正常妊娠组)及95例胎儿窘迫孕妇(胎儿窘迫组)测定血清HIF-1α水平,同时进行胎心监护分析及新生儿Apgar评分。结果胎儿窘迫组母血HIF-1α水平为105.73±31.12pg/L,明显高于正常妊娠组(41.48±18.91pg/L);其中,胎儿窘迫组胎心监护阳性者,母血HIF-1α水平为138.98±30.56 pg/L;可疑者为94.21±28.93 pg/L,两者的HIF-1α水平均明显高于正常妊娠组,差异有统计学意义(P<0.01);而胎心监护为阴性者母血HIF-1α水平为47.34±18.76pg/L,与正常妊娠组比较,差异无统计学意义(P>0.05);在胎儿窘迫三组间,HIF-1α两两比较,差异有统计学意义(P<0.05)。胎儿窘迫组母血HIF-1α水平与新生儿Apgar评分呈负相关。结论母血HIF-1α水平可作为预测胎儿窘迫的一种新指标,胎心监护联合HIF-1α水平测定可提高判断胎儿宫内缺氧的准确性。

Objective To explore the value of detection of hypoxia- inducible factor- 1α （ HIF- 1α） level in maternal blood and fetal heart rate （FHR）monitoring patterns for fetal distress. Methods Ninety five patients with fetal distress （ fetal distress group） and 40 healthy pregnant women （ control group） were involved in this study. The levels of serum HIF-1α were measured. The fetal heart rate monitoring and the newborn Aparg＇s scores were assessed. Results The levels of HIF-1 α in maternal blood in fetal distress group were markedly higher than that in control group （105.73±31.12 vs 41.48± 18.91 pg/L）. In fetal distress group, as for HIF-1α levels in maternal blood, the fetal heart monitoring positive was 138.98± 30.56 pg/L, the suspicious person was 94.21±28.93 pg/L, they were all significantly higher than that in the control group（ P 〈 0.01 ）. The fetal heart monitoring negative was 47.34± 18.76pg/L. There was no significant difference between the fetal heart monitoring negative and the control group （ P 〉 0.05 ）. A significant difference was found in three groups withthe fetal distress （ P 〈 0. 05 ）. The level of HIF- 1α in maternal blood was negative correlated with newborn Aparg＇s score. Conclusion The level of HIF-1α in maternal blood can be used as a new index of predicting fetal distress. The fetal heart monitoring combined determination of HIF-1α could improve the accuracy of assessment of intrauterine fetal anoxia.