妊娠合并糖尿病母亲新生儿脐血S100B蛋白、NSE、MBP水平及NBNA相关性研究  

Studies of S100B Protein, NSE and MBP Level in Neonatal Umbilical Cord Blood from Mother with Pregnancy Associated with Diabetes and Correlation with NBNA

作　　者：方敏[1] 黄绮薇[2] 方阅[3] 

机构地区：[1]上海交通大学附属第一人民医院产科,上海200080 [2]上海交通大学附属儿童医院新生儿科,上海200040 [3]上海交通大学附属第一人民医院药剂科,上海200080

出　　处：《中国医药导刊》2014年第8期1253-1256,1262,共5页Chinese Journal of Medicinal Guide

摘　　要：目的:探讨妊娠合并糖尿病母亲分娩的新生儿脐血血清中S100B蛋白、神经元特异性烯醇化酶(neuron-specific enofase,NSE)、髓鞘碱性蛋白(myelin basic protein,MBP)水平分别与新生儿行为神经测定(Neonatal Behavioral Neurological Assessment,NBNA)评分的相关性。方法:2012年9月至2013年3月在上海交通大学附属第一人民医院产科常规产前检查及分娩的176例单胎孕妇及其分娩的新生儿。参照《2011年妊娠合并糖尿病诊治推荐指南》,将这些产妇分为:血糖正常孕妇组(n=59例)、糖尿病合并妊娠组(DM组,n=32例)、妊娠期糖尿病组(GDM组);同时根据GDM组患者是否应用胰岛素分为无胰岛素治疗组(GDM-A1组,n=44例)和胰岛素治疗组(GDM-A2组,n=41例)。其中DM组、GDM-A1组和GDM-A2组所分娩的新生儿为实验组。同期孕周相似、血糖正常孕妇所分娩的新生儿为对照组。采用双抗体夹心酶联免疫吸附实验(ELISA)法测定新生儿脐血S100B蛋白、MBP水平。采用电化学方式测定新生儿脐血NSE水平。同时生后3天对新生儿进行新生儿行为神经测定(NBNA)。结果:(1)对照组、GDM-A1组、GDM-A2组、DM组新生儿脐血血清S100B蛋白、NSE、MBP水平组间差异显著(F=13.067,F=14.428,F=8.772,P<0.05)。且与对照组比较,GDM-A1组、GDM-A2组、DM组新生儿脐血血清S100B蛋白、NSE水平上升明显,差异有统计学意义(P<0.05);与对照组比较,GDM-A2组新生儿脐血血清MBP水平升高,差异有统计学意义(P<0.05)。(2)对照组、GDM-A1组、GDM-A2组、DM组NBNA评分水平组间差异显著(F=7.002,P<0.05)。且与对照组比较,GDM-A1组、GDM-A2组、DM组NBNA评分降低明显,差异有统计学意义(P<0.05)。(3)妊娠合并糖尿病母亲所分娩的新生儿脐血血清S100B蛋白、NSE水平分别与NBNA评分呈负相关(r=-0.0159,r=-0.0177,P<0.05),新生儿脐血血清MBP水平与NBNA评分无相关性(r=-0.0992,P>0.05)。结论:脐血S100B蛋白、NSE、MBP这三种分子作为新生儿�To explore the correlation of S100B protein, neuron-speciifc enofase （NSE） and myelin basic protein （MBP） level in Umbilical cord blood serum from mother with pregnancy associated with diabetes and the neonatal behavior neurological assessment （NBNA） score.Methods：Recommended guidelines of diagnosis and treatment of pregnancy with diabetes in 2011 were performed in 176 pregnant women who had antenatal care and delivered in the department of obstetrics and gynecology of ifrst afifliated people’s hospital of Shanghai Jiaotong University from September 2012 to March 2013. These women were divided into four groups： normal glucose level（n=59）, DM （n=32）, GDM of non-using insulin （GDM-A1,n=44） and GDM of using insulin （GDM-A2, n=41）. The experiment group were collected with childbirth by the pregnancy associated with diabetes mother, including DM, GDM-A1, GDM-A2 group. The control group of normal glucose level pregnant women in hospital childbirth without perinatal hypoxia was chosen in the same period. The ELISA method was used for all newborn umbilical cord blood called S100B protein and MBP level detection. NSE was used for the electrochemical determination of neonatal umbilical cord blood levels. NBNA score was determined in all selected objects children such as 3 days after born.Results：（1） The control group, the GDM-A1 group, GDM-A2 group and DM group of umbilical cord blood serum S100B protein, NSE, MBP level were signiifcant differences between groups （ F=13.067, F=13.067, F=8.772,P0.05）.Conclusion：Original S100B protein ,NSE and MBP of umbilical cord blood serum were lower expression proteins in neonatal central nervous system. The higher expression level of these three molecules prompt the neonates of pregnancy associated with diabetes had brain injury. Jointing detection of S100B protein, NSE, MBP and Neonatal Behavioral Neurological Assessment （NBNA） is of great signiifcance to detect neonatal brain injury situation in the early.

关 键 词：妊娠合并糖尿病 S100B蛋白 NSE MBP NBNA 

分 类 号：R714.256[医药卫生—妇产科学]