母血及脐血中血清蛋白指标与胎儿生长发育的关系

Mother Blood and Umbilical Cord Blood Serum Protein Indicators and Fetal Growth and Development

目的探讨母血及脐血中白蛋白（s ALB）、转铁蛋白（TRF）、视黄醇结合蛋白（RBP）、前白蛋白（PA）与胎儿生长发育的关系。方法选择2012年11月至2013年10月在佛山市南海区桂城医院单胎足月（≥37孕周）分娩的产妇115例,按胎儿出生体质量分为三组：低体质量（〈2.5 kg）组30例,正常体质量（2.0~4.0 kg）组61例,超重组（≥4.0 kg）24例。采用血清生化及酶联免疫吸附试验检测母血及新生儿脐血中s ALB、RBP、PA、TRF水平。结果母血及脐血s ALB水平在三组之间的差异均无统计学意义（P〉0.05）。三组中脐血RBP、PA、TRF水平显著低于母血水平（P〈0.05）,脐血RBP、PA、TRF水平在低体质量组分别为（16.99±7.71）mg/L、（11.46±3.31）g/L、（1.65±0.36）g/L,在正常体质量组分别为（24.19±27.19）mg/L、（10.49±2.43）g/L、（1.69±0.47）g/L,在超重组分别为（26.68±33.33）mg/L、（13.15±4.98）g/L、（1.76±0.52）g/L;母血RBP、PA、TRF水平在低体质量组分别为（44.35±15.40）mg/L、（26.69±6.86）g/L、（4.10±0.51）g/L,在正常体质量组分别为（37.15±11.17）mg/L、（21.64±5.63）g/L、（4.00±0.47）g/L,在超重组分别为（36.22±15.59）mg/L、（20.69±5.10）g/L、（3.90±0.58）g/L。低体质量组母血及脐血RBP、PA水平均显著低于正常体质量组（P〈0.05）,母血及脐血TRF水平高于正常体质量组（P〈0.05）;超重组母血及脐血RBP、PA水平均显著高于正常体质量组（P〈0.05）,母血及脐血TRF水平与正常体质量组的差异无统计学意义（P〉0.05）。母血及脐血RBP、PA水平与新生儿出生体质量直接相关（r=0.482、0.437,P〈0.05）。结论母血及脐血RBP、PA水平与新生儿出生体质量直接相关,是反映母儿营养状况的敏感指标。

Objective To explore the relationships between the mother blood and umbilical cord blood albumin （sALB）, transferrin （TRF）, retinol binding protein （RBP）, prealbumin （PA） and fetal growth/ development. Methods From Nov. 2012 to Oct. 2013,115 cases of delivery of full-term（ ≥37 weeks） singleton were selected from Guicheng Hospital of Nanhai District in Foshan,according to the birth weight they were divided into three groups：low weight（ 〈2.5 kg） group of 30 cases,normal weight（2.5 kg≤body mass 〈 4.0 kg） group of 61 cases, overweight（ ≥4.0 kg） group of 24 cases. Serum biochemical and enzyme-linked immunosorbent assay were used to detect sALB, RBP, PA and TRP in blood and neonatal umbilical cord blood. Results Mother blood and umbilical cord blood sALB level had no significant difference between the three groups（ P 〉 0.05 ） ;umbilical cord blood RBP, PA, TRF were significantly lower than the mother blood level（ P 〈 0.05 ）in the three groups. Umbilical cord blood RBP,PA, TRF level of the low birth weight group were （ 16.99 ± 7.71 ） mg/L, （ 11.46 ± 3.31 ） g/L, （ 1.65 ± 0. 356 ） g/L respectively; of the normal body weight group were （24.19 ± 27.19 ） mg/L, （ 10.49 ± 2.43 ） go/L, （ 1. 691 ± 0. 474 ） g/L respectively; of the overweight group were （26.68 ± 33.33 ） mg/L, （ 13.15 ± 4.98 ） g/L, （ 1. 762 ± 0.516 ） g/L respectively. The mother blood RBP,PA,TRF level of the low birth weight group were （44.35 ± 15.40） rag/L, （26.69 ± 6.86）g/L, （4.10 ± 0.51 ）g/L respectively; of the normal weight group were RBP, PA, TRF（37. 15 ± 11.17 ） rag/L, （21.64 ± 5.63 ） g/L, （4.00 ± 0.47 ） g/ L respectively; of the overweight group were RBP, PA, TRF（36.22 ± 15.59 ） mg/L, （20.69 ± 5.10 ） g/L, （3.90 ± 0.58 ） g/L respectively. RBP, PA levels of mother blood and cord blood in low birth weight group were significantly lower than the normal birth weight group（ P 〈0.05 ）. TRF level of the mother blood and umhilieal cord blood was higher than the normal birth weight group（P 〈0.05）. Mother blood and umbilical cord blood RBP, PA levels of overweight group were significantly higher than the normal birth weight group（ P 〈 0.05 ）. Mother blood and umbilical cord blood TRF had no significant difference from the normal birth weight group （ P 〉 0.05 ）. RBP, PA levels of the mother blood and umbilical cord blood were directly related to birth weight （ r = 0. 482,0. 437, P 〈 0.05 ）. Conclusion RBP, PA levels of mother blood and umbilical cord blood are directly related to birth weight, which are sensitive indicators to reflect the nutritional status of mother and child.