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目的探讨窒息缺氧对新生儿血清瘦素(Lp)与血脂水平的影响。方法2004-03—2005-08对暨南大学第五附属医院52例窒息新生儿出生后第1天、第5天、第10天血清Lp、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(apoA1)及载脂蛋白B(apoB)进行测定,以32例健康新生儿作对照。结果窒息患儿生后第1天血清Lp水平[(4.06±3.02)ng/mL]显著低于对照组[(12.87±5.71)ng/mL](P<0.05),且随窒息程度加重而显著减少;窒息患儿TG[(0.76±0.47)mmol/L]、apoA1[(1.08±0.24)g/L]显著高于对照组,HDL-C[(0.69±0.40)mmol/L]显著低于对照组,均P<0.05。27例窒息患儿第5d与第1d相比,TC、LDL-C与apoB明显升高(P<0.05),而与第10d比较则无差异(P>0.05),HDL-C、apoA1到第10d明显升高,TG保持稳定。Lp水平与TC、TG、LDL-C、apoB的水平呈负相关(P<0.05),与apoA1、HDL-C无相关性(P>0.05)。结论窒息缺氧可导致新生儿瘦素与血脂代谢紊乱;瘦素可能参与了窒息新生儿血脂代谢紊乱的发病过程。
Objective To investigate the effects of asphyxia and hypoxia on serum leptin (Lp) and blood lipid levels in neonates. Methods From March 2004 to August 2005, 52 neonates with asphyxia at the Fifth Affiliated Hospital of Jinan University were enrolled in the study. Serum Lp, total cholesterol (TC), triglyceride (TG) (HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (apoA1) and apolipoprotein B (apoB) were detected in 32 healthy newborns. Results Serum Lp level (4.06 ± 3.02 ng / mL) was significantly lower than that of control group [(12.87 ± 5.71) ng / mL] on the first day after birth (P <0.05), and significantly increased with the degree of asphyxia (0.68 ± 0.47) mmol / L] and apoA1 [(1.08 ± 0.24) g / L] in asphyxia group were significantly higher than those in control group The levels of TC, LDL-C and apoB in the asphyxia group were significantly higher than those in the control group (P <0.05), but no significant difference compared with the 10th day (P> 0.05) , HDL-C, apoA1 significantly increased to the first 10 days, TG remained stable. The level of Lp was negatively correlated with TC, TG, LDL-C and apoB (P <0.05), but not with apoA1 and HDL-C (P> 0.05). Conclusion Asphyxia and hypoxia can lead to the imbalance of leptin and lipid metabolism in neonates. Leptin may be involved in the pathogenesis of dyslipidemia in neonates with asphyxia.