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目的:探讨胎儿窘迫伴(或不伴)羊水粪染的新生儿脐血中8-异前列腺素(8-iso-PGF2α)水平的变化及其临床意义。方法:选取胎儿窘迫伴(或不伴)羊水粪染的新生儿152例,进行出生后1 min Apgar评分,按羊水粪染情况分为无粪染组36例和Ⅰ度粪染组38例、Ⅱ度粪染组39例、Ⅲ度粪染组39例,并选取同期正常新生儿38例为对照组。采用双抗体夹心酶联免疫法检测五组新生儿脐血8-iso-PGF2α水平并对结果进行分析。结果:(1)胎儿窘迫病情越严重,患儿血清8-iso-PGF2α水平越高,体内氧化应激反应越严重,特别是羊水粪染≥Ⅱ度时,患儿血清8-iso-PGF2α水平明显高于正常新生儿、无或Ⅰ度粪染患儿(P<0.05);(2)Apgar评分≤8分患儿血清8-iso-PGF2α水平高于正常新生儿及9~10分患儿(P<0.05);(3)以8-iso-PGF2α水平为检验变量,是否窘迫为状态变量,作ROC曲线分析,曲线下面积(AUC)为0.880,95%CI为0.835-0.901,以8-iso-PGF2α水平判断是否有胎儿窘迫的Cut-off值为4.23 ng/m L。结论:胎儿窘迫的发生发展与过氧化损伤有关,脐血8-iso-PGF2α水平能够准确反映胎儿窘迫羊水粪染新生儿过氧化损伤的程度,与Apgar评分能够共同作为及时预测新生儿缺血缺氧性脑病发生的指标。
Objective: To investigate the changes of 8-iso-prostaglandin (8-iso-PGF2α) in neonatal umbilical blood with fetal distress and / or meconium-stained amniotic fluid and its clinical significance. Methods: A total of 152 neonates with fetal distress and / or meconium-stained amniotic fluid were selected for Apgar score at 1 min after birth. According to the meconium-stained amniotic fluid, 36 cases were non-meconium-stained and 38 cases were meconium- 39 cases of Ⅱ meconium-stained group and 39 cases of Ⅲ meconium-stained group, and 38 normal newborns were selected as the control group. The levels of 8-iso-PGF2α in cord blood of five neonates were detected by double antibody sandwich enzyme-linked immunosorbent assay and the results were analyzed. Results: (1) The more serious the fetal distress, the higher the level of 8-iso-PGF2α in serum, the more severe the oxidative stress in the body, especially the level of 8-iso-PGF2α (2) The level of 8-iso-PGF2α in children with Apgar score ≤8 was significantly higher than that in normal newborns and children with 9-10 infants (P <0.05). (3) The 8-iso-PGF2α level as a test variable, whether distress as a state variable for ROC curve analysis, the area under the curve (AUC) was 0.880, 95% CI 0.835-0.901, with 8 -iso-PGF2α levels to determine whether there is a cut-off value of fetal distress of 4.23 ng / m L. Conclusion: The occurrence and development of fetal distress is related to the injury of peroxidation. The level of 8-iso-PGF2α in umbilical cord blood can accurately reflect the extent of peroxidation damage in newborns with amniotic fluid stained with fetal amniotic fluid and with Apgar score as a timely prediction of neonatal ischemia Oxygen encephalopathy occurrence of indicators.