围生期窒息对不同胎龄新生儿血清酶和IGF-1水平的影响

Effect of perinatal asphyxia on serum enzymes and IGF-1 in neonates of different gestational age

目的探讨围生期窒息对不同胎龄新生儿血清酶和胰岛素样生长因子(IGF-1)水平的影响。方法将60例围生期窒息新生儿及23例正常新生儿作为研究对象,均排除引起血清酶活性变化的非围生期窒息因素。围生期窒息新生儿根据窒息程度分为重度窒息组27例(足月儿15例,早产儿12例)和轻度窒息组33例(足月儿18例,早产儿15例),23例正常新生儿(足月儿10例,早产儿13例)作为正常组。生后24 h内采集所有新生儿股静脉血,检测谷草转氨酶(AST)、乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(α-HBDH)和胰岛素样生长因子(IGF-1)水平。结果重度窒息组和轻度窒息组早产儿和足月儿IGF-1水平均明显低于正常组早产儿和足月儿(P均<0.05),且重度窒息组明显低于轻度窒息组(P<0.05)。重度窒息组早产儿AST、LDH、α-HBDH水平均明显高于轻度窒息组和正常组早产儿(P均<0.05),而轻度窒息组与正常组比较差异均无统计学意义(P均>0.05);重度窒息组和轻度窒息组足月儿AST、LDH、α-HBDH水平均明显高于正常组足月儿(P均<0.05),且重度窒息组均明显高于轻度窒息组(P均<0.05)。正常足月儿与早产儿IGF-1水平比较差异无统计学意义(P>0.05);正常早产儿血清AST、LDH、α-HBDH水平均明显高于正常足月儿(P均<0.05)。结论新生儿血液中血清酶和IGF-1水平的监测有助于新生儿窒息的早期诊断,围生期窒息对新生儿的影响具有胎龄差异性,血清酶的变化有助于了解窒息的程度。

Objective It is to investigate the effects of perinatal asphyxia on serum enzymes and insulin like growth factor（ IGF-1） in neonates of different gestational age. Methods 60 cases of perinatal asphyxia and 23 normal newborns were studied as the research object,who were excluded the factors of non-perinatal asphyxia which could cause change of serum enzymes. The newborns with perinatal asphyxia were divided into severe group with 27 cases（ 15 normal term infants and 12 premature infants） and mild group with 33 cases（ 10 normal term infants and 13 premature infants） and normal group（ 10 normal term infants and 13 premature infants）. In 24 hours after born femoral venous blood was gotten to determine the levels of aminotransferase（ AST）,lactate dehydrogenase（ LDH）,α-bybutyric acid dehydrogenase（ α-HBDH） and IGF-1. Results The levels of IGF-1 severe group and mild group were significantly lower than that in normal group（ P〈0. 05）,and the level in severe group was lower than that in mild group（ P〈0. 05）. The levels of AST,LDH,α-HBDH in premature infants in severe group were significantly higher than that in the ones in mild group and normal group（ P〈0. 05）,but there was no significant difference between mild group and normal group（ P〉0. 05）. The levels of AST,LDH,α-HBDH in normal term infants in severe group and mild group were significantly higher than that in the ones in normal group（ P〈0. 05）,and the decrease in severe group was more significant compared with that in mild group（ P〈0. 05）. There was no significant difference in the level of IGF-1 between normal term infants and premature infants in normal group（ P〉0. 05）. The levels of AST,LDH and α-HBDH in premature infants were higher than that in normal term infants in normal group（ P〈0. 05）. Conclusion Neonatal blood serum enzyme and the level of IGF-1 monitoring is helpful for the early diagnosis of neonatal asphyxia,asphyxia of newborn in the perinatal period with gestational age difference,the change of serum enzyme is helpful for the understanding of the degree of asphyxia.