妊娠期糖尿病母亲新生儿脐血MMP-9、SICAM-1水平与NBNA的相关性研究

Cord blood concentration of matrix metalloproteinase-9, soluble intercellular adhesion molecule and its associations with neonatal behavior neurological assessment in term neonate with mothers of gestational diabetes

目的观察妊娠期糖尿病母亲婴儿脐血中基质金属蛋白酶-9(MMP-9)、可溶性细胞粘附分子-1(SICAM-1)水平变化,探讨MMP-9、SICAM-1与新生儿神经行为测定(NBNA)的相关性。方法采用双抗体夹心酶联免疫吸附实验(ELISA)法测定33例妊娠期糖尿病母亲新生儿脐血MMP-9、SICAM-1水平,在三天后对新生儿进行神经行为测定(NBNA评估),同时与血糖正常母亲新生儿进行对照;并对MMP-9、SICAM-1水平与NBNA评分进行相关性分析。结果糖尿病母亲组新生儿脐血MMP-9、SICAM-1水平较正常对照组明显升高,差异有统计学意义(P<0.05);糖尿病母亲组新生儿NBNA水平低于正常对照组,组间差异有统计学意义(P<0.05)。糖尿病母亲组新生儿脐血MMP-9、SICAM-1水平与NBNA评分呈负相关(rs分别为-0.618、-0.549;P<0.05),正常对照组新生儿脐血MMP-9、SICAM-1水平与NBNA评分无明显相关性(rs分别为-0.125、-0.098;P>0.05)。结论母亲妊娠期糖尿病时,新生儿出生时脐静脉血MMP-9、SICAM-1水平可发生明显变化,监测其水平,可以为以后的妊娠期糖尿病母亲婴儿的脑损伤的诊断、治疗和随访提供临床依据。

Objective To examine whether matrix metalloproteinase-9, soluble intercellular adhesion molecule have change in umbilical blood with gestational diabetes mothers, and explore if there are correlations between MMP-9, SICAM-1 and neonatal behavior neurological assessment. Methods Detect the levels of umbilical cord blood MMP-9, SICAM-1 in 33 newborns deliveried by gestational diabetes mothers and 50 healthy mothers’neonates by ELISA. DO NBNA text of all neonates at 3 days, then explore the correlations between MMP-9, SICAM-1 and NBNA. Results The umbilical cord blood MMP-9 and SICAM-1 in GDM group was significantly higher compared with normal group (P<0.05). Spearman’s rank correlation analysis showed significantly negative correlations between NBNA and MMP-9 (rs=-0.618, P<0.05) and SICAM-1 (rs=-0.549, P<0.05) in GDM group, but NBNA did not relate with MMP-9 (rs=-0.125, P>0.05) and SICAM-1 (rs=-0.098, P>0.05) in normal group. Conclusion Umbilical cord blood MMP-9 and SICAM-1 increase significantly in GDM, have negative correlations with NBNA. Umbilical cord blood MMP-9 and SICAM-1 may provide earlier index for brain injured diagnose, treatment and follow up visit.