不同分娩方式对脐带动静脉血中蛋白质、葡萄糖和血脂水平的影响

Effect of different delivery modes on the level of protein,glucose and blood lipids in cord artery and vein blood

目的探讨不同分娩方式的新生儿脐静脉和脐动脉血中蛋白质、葡萄糖和血脂水平是否存在差异,并评价其作为胎儿宫内营养状况及营养支持指标的价值。方法选取2021年6—9月在江苏省丹阳市人民医院住院分娩的89对母婴作为研究对象,其中顺产38例,剖宫产51例。从医院的病历信息系统中提取孕妇的基本信息、妊娠期信息、新生儿分娩和体格检查信息等。根据分娩方式分组,采用HITACHI 7600全自动生化分析仪进行进行脐静脉和脐动脉血蛋白质、葡萄糖和血脂水平测定,包括总蛋白(total protein,TP)、白蛋白(albumin,ALB)、葡萄糖(glucose,GLU)、总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)。采用IBM SPSS Statistics 26.0统计学软件对数据进行统计学分析。结果顺产组脐静脉血中TP、ALB、GLU、TC、TG、HDL-C、LDL-C水平分别为(56.40±5.83)g/L、(38.41±3.43)g/L、(4.55±1.53)mmol/L、(1.68±0.42)mmol/L、(0.25±0.11)mmol/L、(0.84±0.17)mmol/L和(0.69±0.23)mmol/L;脐动脉血中TP、ALB、GLU、TC、TG、HDL-C、LDL-C水平分别(56.49±9.91)g/L、(37.72±4.77)g/L、(4.07±1.52)mmol/L、(1.60±0.42)mmol/L、(0.24±0.10)mmol/L、(0.80±0.18)mmol/L和(0.68±0.24)mmol/L。剖宫产组脐静脉血中TP、ALB、GLU、TC、TG、HDL-C、LDL-C水平分别为(52.08±4.12)g/L、(36.12±2.13)g/L、(3.45±1.16)mmol/L、(1.61±0.39)mmol/L、(0.19±0.08)mmol/L、(0.82±0.18)mmol/L和(0.61±0.20)mmol/L;脐动脉血中TP、ALB、GLU、TC、TG、HDL-C、LDL-C水平分别为(51.49±7.59)g/L、(35.40±3.60)g/L、(3.09±1.15)mmol/L、(1.48±0.40)mmol/L、(0.19±0.08)mmol/L、(0.78±0.18)mmol/L和(0.60±0.20)mmol/L。顺产组脐静脉和脐动脉血中TP、ALB、GLU、TG水平均显著高于剖宫产组(P<0.05);顺产组和剖宫产组脐静脉血中GLU、TC、TG、HDL-C水平均显著高于脐动脉血(P<0.05)。结论脐静脉和脐动脉血中蛋白质、葡萄糖和血脂水平在不同分娩方式间存在差异。

OBJECTIVE To explore whether there are differences in the levels of protein,glucose and blood lipids in umbilical vein and umbilical artery blood of newborns with different delivery modes,and to evaluate their value as indicators of fetal intrauterine nutrition and nutritional support.METHODS A total of 89 pairs of mothers and infants who were delivered in Danyang People's Hospital of Jiangsu Province from June to September 2021 were selected as the study subjects,including 38 cases of spontaneous delivery and 51 cases of cesarean section.The basic information of pregnant women,pregnancy information,newborn delivery and physical examination information were extracted from the medical record information system of the hospital.According to the mode of delivery,HITACHI 7600 automatic biochemical analyzer was used to measure the levels of protein,glucose and blood lipids in umbilical vein and umbilical artery blood,including total protein(TP),albumin(ALB),glucose(GLU),total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C).The data were statistically analyzed using IBM SPSS Statistics 26.0 statistical software.RESULTS The levels of TP,ALB,GLU,TC,TG,HDL-C and LDL-C in the umbilical vein blood of the spontaneous delivery group were(56.40±5.83)g/L,(38.41±3.43)g/L,(4.55±1.53)mmol/L,(1.68±0.42)mmol/L,(0.25±0.11)mmol/L,(0.84±0.17)mmol/L and(0.69±0.23)mmol/L,respectively.The levels of TP,ALB,GLU,TC,TG,HDL-C and LDL-C in umbilical artery blood were(56.49±9.91)g/L,(37.72±4.77)g/L,(4.07±1.52)mmol/L,(1.60±0.42)mmol/L,(0.24±0.10)mmol/L,(0.80±0.18)mmol/L and(0.68±0.24)mmol/L,respectively.The levels of TP,ALB,GLU,TC,TG,HDL-C and LDL-C in umbilical vein blood of cesarean section group were(52.08±4.12)g/L,(36.12±2.13)g/L,(3.45±1.16)mmol/L,(1.61±0.39)mmol/L,(0.19±0.08)mmol/L,(0.82±0.18)mmol/L and(0.61±0.20)mmol/L,respectively.The levels of TP,ALB,GLU,TC,TG,HDL-C and LDL-C in umbilical artery blood were(51.49±7.59)g/L,(35.40±3.60)g/L,(3.09±1.15)mmol/L,(1.48±0.40)mmol/L,(0.19±0.08)mmol/L,(0.78±0.18)mmol/L and(0.60±0.20)mmol/L,respectively.The levels of TP,ALB,Glu and TG in cord vein blood and cord artery blood in spontaneous labor group were significantly higher than those in cesarean section group(P<0.05);The levels of Glu,TC,TG and HDL-C in cord vein blood were significantly higher in spontaneous labor group and cesarean section group than those in cord artery blood(P<0.05).CONCLUSION The levels of protein,glucose and blood lipids in umbilical vein and umbilical artery blood were different among different delivery modes.