围产期窒息母儿血浆催乳素水平变化研究

Study on the dynamic changes of the plasma prolactin levels in maternal and newborn infants blood with perinatal asphyxia

为探讨窒息新生儿母、儿血浆催乳素 (PRL)水平变化与相关性及其意义 ,采用放射免疫分析法对25例围产期窒息儿及20例正常对照组母血、脐血及新生儿血浆PRL水平进行测定并进行动态观察。结果显示窒息组母血、脐血及新生儿血浆PRL水平均显著高于正常对照组 (P均<0.01) ;重度窒息组母血、脐血及新生儿血浆PRL水平均高于轻度窒息组 ,差异具有显著性(P<0.01 ,<0.001,<0.01) ,窒息儿母血、脐血及新生儿血浆PRL水平具有显著的正相关关系 (r=0.54,P<0.05)。窒息新生儿复苏后血浆PRL水平显著增高 ,生后第2dPRL水平逐渐下降 ,生后第10d血浆PRL水平虽高于正常对照组 ,但差异无显著性 (P>0.05)。提示围产期窒息新生儿血浆、脐血、母血PRL水平显著增高 ,其可能的机理是窒息时缺氧缺血导致脑组织释放兴奋性氨基酸增加 ,进而刺激垂体前叶释放PRL ,导致血浆及脐血PRL水平增高。因此认为 ,血浆PRL水平可作为判断新生儿窒息程度及由窒息缺氧所致新生儿脑损伤恢复状况的一项参考指标。

To explore the correlation of the dynamic changes in plasma prolectin(PRL)levels in materˉnal and newborn's blood with perinatal asphyxia and their significance.The plasma prolactin levels in maˉternal,cord and newborn's blood were measured dynamically in25newborns and their mathers with perinatal asphyxia as the patient's group and20normal delivered newborns as well as their mothers as the normal control group with the radioimmunoassay.The results showed that the plasma PRL levels in maternal,cord and newborn's blood in patients group were much higher than those in normal control group(P<0.05).The plasma prolactin levels in severe asphyxia patients group were remarkably higher than those in the interˉmediate severity of the asphyxia patients group with significant difference(P<0.01,P<0.05,P<0.05respectively).There were great positive correlation in the plasma PRL levels of the maternal,cord and newborn's blood with perinatal asphyxia(r=0.54,P<0.05),but with the successful resuscitation.The plasˉma PRL levels in newborn with asphyxia were markedly increased,then in the second day after birth.The plasma PRL level decreased gradually and reached a little higher level at10days than that in normal control group with no significance(P>0.05)indicating that the plasma PRL levels in maternal,cord and newborn infants blood with perinatal asphyxia were significantly higher.The possible pathogenesis was that hypoxia and ischemia in asphyxia could result in brain tissue to release excitary amino acid increase,then further stimulating the anterior pituitary to release PRL increase.So,the plasma PRL levels could considered as a good reference index for evaluating the severity of the asphyxia in newborn infants and recovery of brain damage resulting from asphyxia and hypoxia in newborn infants.