新生儿脐带血促肾上腺皮质激素、皮质醇水平的影响因素研究

Influencing factors of adrenocorticotrophic hormone and cortisol in neonatal cord blood

目的分析健康足月儿促肾上腺皮质激素(ACTH)、皮质醇(COR)的水平及其影响因素,为新生儿的预防保健提供理论支持。方法选取2018年10月-2019年2月空军医学特色中心妇产科出生的88例新生儿为研究对象,检测脐带血ACTH、COR水平,用最优尺度回归分析的方法探讨分娩方式、胎龄、性别、出生体重、母亲孕期情况对新生儿脐带血ACTH、COR水平的影响。结果88例新生儿脐带血ACTH水平为(172.11±93.93)pg/ml,COR水平为(310.05±125.33)ng/ml。单因素分析结果显示,不同分娩方式、胎龄的新生儿脐带血COR水平的差异具有统计学意义(P<0.01),而不同性别、出生体重、母亲孕期健康情况的新生儿COR水平差异无统计学意义,不同分娩方式、胎龄、性别、出生体重、母亲孕期情况的新生儿的ACTH水平差异无统计学意义(P>0.05)。最优尺度回归分析显示,分娩方式、性别、胎龄和体重对脐带血COR的水平有显著影响(β=-0.522,-0.221,0.284,-0.260,P<0.05)。结论分娩方式、胎龄是健康足月儿脐带血COR水平的主要影响因素,而本研究所涉及的胎龄、性别、出生体重、母亲孕期情况等均不影响ACTH水平。

Objective To investigate the levels of adrenocorticotrophic hormone(ACTH) and cortisol(COR) in neonates,and to analyze the influencing factors,so as to provide evidence for the health care of neonates. Methods A total of 88 neonates born in the Obstetrical Department of Air Force Medical Center were enrolled in this study from October 2018 to February 2019. The levels of ACTH and COR in umbilical cord blood in 88 neonates were tested. And categorical regression method was used to analyze the effects of parturition mode,gestational age,gender,birth weight and maternal health during pregnancy on the levels of ACTH and COR in umbilical cord blood. Results The levels of ACTH and COR in 88 neonates were (172.11±93.93) pg/ml and (310.05±125.33) ng/ml,respectively. Single factor analysis showed that there were statistically significant differences on COR level of umbilical cord blood among neonates with different parturition modes and gestational age(P<0.01),while it was not significant on COR level among children with different gender,birth weight and maternal health during pregnancy(P>0.05). Moreover,these variables had no significant influence on ACTH level(P>0.05). The optimal scale regression analysis showed that parturition mode(β=-0.522),gender(β=-0.221),gestational age(β=0.284) and body weight(β=-0.260) had significant effects on the level of cord blood COR in neonates(P<0.05). Conclusion Parturition mode and gestational age are the main influencing factors of COR level in umbilical cord blood in healthy full-term newborns,while the gestational age,gender,birth weight and maternal pregnancy status involved in this study do not affect the level of ACTH.