不同分娩方式对足月新生儿脐血皮质醇水平的影响及其与新生儿湿肺的关系  

The Cord Cortisol Level of Term Neonates in Different Delivery Mode and its Relationship with Transient Tachypnea of Newborn

作　　者：武宜亮[1] 董自江[1] 朱礼刚[1] 肖志辉[2] 

机构地区：[1]连云港市第一人民医院,江苏连云港222003 [2]苏州大学附属儿童医院,江苏苏州215000

出　　处：《黑龙江医学》2016年第3期214-216,共3页Heilongjiang Medical Journal

摘　　要：目的分析不同分娩方式对足月新生儿脐血皮质醇水平的影响及其与并发新生儿湿肺(tachypnea of newborn,TTN)的关系,进一步揭示选择性剖宫产足月儿TTN的发病机理,为选择性剖宫产足月儿TTN的早期防治提供理论依据。方法根据分娩方式的不同将120例新生儿分为选择性剖宫产组60例、非选择性剖宫产组30例、自然分娩组30例,其中选择性剖宫产组分为选择性剖宫产TTN组(并发TTN)30例及选择性剖宫产对照组(未并发TTN)30例。在足月新生儿娩出5 min内留取脐静脉血备检,应用电化学发光法测定其脐血皮质醇含量并进行比较。结果 (1)选择性剖宫产组脐血皮质醇水平低于非选择性剖宫产组及自然分娩组,差异有统计学意义(P<0.01)。(2)选择性剖宫产TTN组脐血皮质醇水平低于选择性剖宫产对照组,差异有统计学意义(P<0.01)。(3)选择性剖宫产组及选择性剖宫产TTN组中男性与女性脐血皮质醇水平差异无统计学意义(P>0.05)。结论选择性剖宫产足月儿脐血皮质醇水平低于非选择性剖宫产儿及自然分娩儿,其机理可能与选择性剖宫产儿的应激状态不完善有关;选择性剖宫产足月儿脐血皮质醇水平降低可能与TTN的发生密切相关。Objective To investigate the cord cortisol level of term neonates in different delivery mode and its relationship with transient tachypnea of newborn（ TTN） in term neonates delivered by elective cesarean section,further reveal the pathogenesis of TTN,and provide a theoretical basis for the early prevention and treatment of TTN.Methods According to the different mode of delivery,samples were divided into three groups： 60 cases of elective cesarean section group,30 cases of non-elective cesarean section group,and 30 cases of normal delivered group.Elective cesarean section group were divided into two groups： 30 cases of TTN group and 30 cases of normal control group.Keep the cord blood samples after birth of term neonates within five minutes for detection.Determine the content of cord cortisol with electrochemiluminescence immunoassay（ ECLIA）.Analyzed the results by statistical method.Results 1.The content of cord cortisol in elective cesarean section group was lower than that in non-elective cesarean section group and normal delivered group,which showed highly significant differences（ P 〈0.01）.2.Within elective cesarean section group,the content of cord cortisol in TTN group was lower than that in normal control group,which showed highly significant differences（ P 〈0.01）.3.Within elective cesarean section group and TTN group,there was no significant difference between male group and female group in the content of cord cortisol（ P 〈0.05）.Conclusion The cord cortisol level in elective cesarean section term neonates was lower than that in non-elective cesarean section term neonates and normal delivered term neonates,its mechanism may be related to elective cesarean section stress state was not perfect; The decrease of cord blood cortisol level in term neonates delivered by elective cesarean section probably showed a close relationship with the incidence of TTN.

关 键 词：新生儿 脐血皮质醇 选择性剖宫产 新生儿湿肺 

分 类 号：R722[医药卫生—儿科]