围手术期胎儿宫内缺氧的脐血流超声特征评估及其与母体、胎儿氧化应激损伤的关系

Umbilical blood flow ultrasound characteristics of perioperative fetal intrauterine hypoxia and their relationship with maternal and fetal oxidative stress injury

目的:研究围手术期胎儿宫内缺氧的脐血流超声特征与母体、胎儿氧化应激损伤的关系。方法:选择2014年5月~2016年10月期间在我院分娩的108例产妇,分为新生儿Apgar评分>7分的正常妊娠组和≤7分的宫内缺氧组,采用彩色多普勒超声仪测定脐血流超声参数,采集脐带血并测定氧化应激产物的含量,采集胎盘并测定氧化应激产物及相关凋亡分子的含量。结果:孕24~30周、31~36周、37~41周期间,宫内缺氧组产妇脐血流的RI、PI、S/D均显著高于正常妊娠组;宫内缺氧组产妇脐带血中MDA、oxLDL、8-ios、HSP-70的含量均显著高于正常妊娠组,胎盘组织中MDA、oxLDL、8-ios、HSP-70、Fas、FasL、Bax的含量均显著高于正常妊娠组,Bcl-2、XIAP的含量均显著低于正常妊娠组;RI、PI、S/D与脐带血及胎盘组织中MDA、oxLDL、8-ios、HSP-70的含量呈正相关,与胎盘组织中Fas、FasL、Bax的含量呈正相关,与胎盘组织中Bcl-2、XIAP的含量呈负相关。结论:胎儿宫内缺氧的脐血流阻力增加、流量减少且与母体、胎儿、胎盘的氧化应激损伤程度密切相关。

Objective：To study the relationship between umbilical blood flow ultrasound characteristics of perioperative fetal intrauterine hypoxia and maternal as well as fetal oxidative stress injury.Methods：a total of 108 puerperae giving birth in our hospital between May 2014 and October 2016 were selected and divided into normal pregnancy group with neonatal Apgar score〉7points and intrauterine hypoxia group with neonatal Apgar score≤7points,color Doppler diasonograph was used to determine umbilical blood flow ultrasound parameters,umbilical cord blood was collected to determine the levels of oxidative stress products,and the placenta was collected to determine the levels of oxidative stress products and related apoptosis molecules.Results：During 24-30 weeks,31-36 weeks and 37-41 weeks of pregnancy,umbilical blood flow RI,PI and S/D of intrauterine hypoxia group were significantly higher than those of normal pregnancy group;MDA,oxLDL,8-ios and HSP-70 levels in umbilical cord blood of intrauterine hypoxia group were significantly higher than those of normal pregnancy group,MDA,oxLDL,8-ios,HSP-70,Fas,FasL and Bax levels in placenta tissue were significantly higher than those of normal pregnancy group,and Bcl-2and XIAP levels were significantly lower than those of normal pregnancy group;RI,PI and S/D were positively correlated with MDA,oxLDL,8-ios and HSP-70 levels in umbilical cord blood and placenta tissue,positively correlated with Fas,FasL and Bax levels in placenta tissue,and negatively correlated with Bcl-2and XIAP levels in placental tissue.Conclusions：The increased umbilical blood flow resistance and decreased flow volume of fetal intrauterine hypoxia are closely related to maternal,fetal and placental oxidative stress injury.