不同胎龄新生儿血清雌二醇水平变化及其与早产儿视网膜病的关系

目的 测定不同胎龄新生儿和早产儿视网膜病(retinopathy of prematurity,ROP)患儿血清雌二醇水平变化,探讨其与ROP发生发展的关系.方法 新人院新生儿184例.根据出生胎龄分为＜32周早产儿组、32～37周早产儿组和足月儿组,再根据是否吸氧分为未吸氧和吸氧两个亚 组.出生体重＜2000 g的早产儿均定期眼科筛查,确诊为ROP的患儿作为ROP组.各组分别在生 后第1、3、5、7周用放射免疫法检测血清雌二醇水平.组间结果比较采用非配对t检验和单因素方差 分析.结果 新生儿血清雌二醇水平随着日龄增加迅速下降.在未吸氧新生儿中,32～37周早产 儿组血清雌二醇水平在第1周和第3周分别为(3506±1376)pmol/L和(1431±92)pmol/L,显著高 于足月儿组[分别为(1717±179)pmol/L和(996±102)pmol/L](P均＜0.05);＜32周早产儿组仅第l周[(3173±1369) pmol/L]显著高于足月儿组(P＜0.05).＜32周早产儿血清雌二醇水平在生 后第5周为(560±355)pmol/L,明显低于32～37周早产儿[(1124±128)pmol/L](P＜0.05).在同一胎龄组中,吸氧与未吸氧患儿雌二醇水平差异均无统计学意义.ROP组与＜32周早产儿组血清雌 二醇水平差异无统计学意义.ROP组血清雌二醇水平在纠正胎龄29周和32～36周时低于非ROP 早产儿组,但差异无统计学意义.结论 早产儿低血清雌二醇水平可能与ROP发生有关.

Changes of serum estradiol in newborns and the relationship with retinopathy of prematurity

Objective To observe the serum estradiol level in newborns at different gestational age and the infants with retinopathy of prematurity (ROP), and explore the relationship between these changes and ROP. Methods A total of 178 newborns hospitalized in the Children's Hospital of Fudan University were enrolled in the study. They were divided into three groups based on the gestational age, ＜ 32 weeks group, 32-37 weeks group and term group. The three groups were further divided into non-oxygen and oxygen subgroups. Infants with birth weight less than 2000 g were evaluated for ROP and those diagnosed as ROP were under ROP group (n=6). Serum estradiol levels were measured every week from birth to discharge with radioimmunoassay. Results Serum estradiol levels of newborns quickly declined after birth. In the non-oxygen subgroups, serum estradiol levels in 32 ～ 37 weeks group were remarkably higher than those of term group in the first week [(3506±1376) pmol/L vs (1717±179) pmol/L,P＜0. 05] and the third week [(1431±92) pmol/L vs (996±102) pmol/L, P＜0. 05]; Serum estradiol levels in ＜32 weeks group was only remarkably higher than those of term group in the first week [(3173± 1369) pmol/L vs (1717± 179) pmol/L,P＜0. 05]; Serum estradiol level in the ＜32 week group was (560±355) pmol/L, lower than that in the 32-37 weeks group [( 1124 ± 128) pmol/L] (P＜0. 05). There was no difference of serum estradiol levels in the oxygen and non-oxygen subgroups of the same group. There was no significant difference of serum estradiol levels between the ROP group and ＜32 weeks group. Serum estradiol levels in ROP group was lower than that of premature group without ROP at 29 and 32-36 weeks of corrected gestational age, but no statistical difference was shown. Conclusions Very low serum estradiol level in premature infants may be related to the development of ROP, but further clinical studies are required.