胎儿窘迫孕妇静脉血及脐血中内源性阿片肽水平的测定

目的　探讨内源性阿片肽与胎儿窘迫发生的关系。方法　采用放射免疫法测定 40例正常妊娠妇女 (正常妊娠组 )及 43例胎儿窘迫孕妇 (胎儿窘迫组 )静脉血及其新生儿脐血中阿片肽 (β 内啡肽、强啡肽A1 13和亮啡肽 )的水平 ,胎儿窘迫组孕妇同时行新生儿脐动脉血血气分析。结果　 (1)胎儿窘迫组脐血中 β 内啡肽、强啡肽A1 13和亮啡肽的水平分别为 (45 3± 68)ng/L、(2 42± 3 3 )ng/L及(498± 68)ng/L ;正常妊娠组分别为 (2 5 1± 3 9)ng/L、(10 3± 2 2 )ng/L及 (3 2 2± 40 )ng/L。与正常妊娠组比较 ,胎儿窘迫组脐血中 3种阿片肽水平均显著升高 (P <0 0 5 )。 (2 )胎儿窘迫组脐血血气分析结果 :pH为 (7 0± 0 1) ,PO2 为 (1 7± 0 6)kPa ,PCO2 为 (8 9± 0 7)kPa ;其中 β 内啡肽水平与脐血pH、PO2呈显著负相关 相关系数 (r)为 - 0 418及 - 0 43 7,P <0 0 1],与PCO2 呈显著正相关 (r =0 44 2 ,P <0 0 1) ;强啡肽A1 13水平与脐血pH及PO2 呈负相关 (r为 - 0 3 3 7及 - 0 3 83 ,P <0 0 5 ) ,与PCO2 呈正相关 (r=0 3 46,P <0 0 5 )。 (3 )胎儿窘迫组孕妇血中 β 内啡肽、强啡肽A1 13和亮啡肽水平分别为(40± 13 )ng/L、(64± 16)ng/L及 (2 19± 40 )ng/L ;正常妊娠组分别为 (3 7± 9)ng/L、(5

Study on the relationship between endogenous opioid peptides and fetal distress

OBJECTIVE: To evaluate the role of endogenous opioid peptides (EOP) in the fetal distress. METHODS: Forty three patients with fetal distress (fetal distress group) and 40 healthy pregnant women (control group) in their third trimester were studied. The concentrations of plasma EOP (beta-endorphin, dorphin A(1 - 13) and leu-enkephalin) were measured by radioimmunoassay. Umbilical artery pH, PO(2) and PCO(2) were also measured. RESULTS: The levels of umbilical artery plasma EOP (beta-endorphin, dorphin A(1 - 13) and leu-enkephalin) in fetal distress group were (453 +/- 68) ng/L, (242 +/- 33) ng/L, and (498 +/- 68) ng/L, respectively. In control group, the levels of EOP were (251 +/- 39) ng/L, (103 +/- 22) ng/L, and (322 +/- 40) ng/L, respectively. The levels of umbilical artery plasma EOP (beta-endorphin, dorphin A(1 - 13) and leu-enkephalin) in fetal distress group were significantly higher than that in the control group (P < 0.01,P < 0.05). The umbilical artery blood gas analysis: pH was (7.0 +/- 0.1), PO(2) was (1.7 +/- 0.6) kPa, PCO(2) was (8.9 +/- 0.7) kPa; the levels of beta-endorphin and dorphin A(1 - 13) were negatively correlated to pH and PO(2) in umbilical artery plasma (P < 0.01; P < 0.05), significant correlation was found between the EOP and PCO(2) (P < 0.05). In fetal distress group, the levels of maternal plasma EOP were (40 +/- 13) ng/L, (64 +/- 16) ng/L and (219 +/- 40) ng/L respectively. In control group, the levels were (37 +/- 9) ng/L, (59 +/- 15) ng/L and (199 +/- 37) ng/L respectively. There was no statistical difference in the levels of maternal plasma EOP between the control group and fetal distress group (P > 0.05). CONCLUSIONS: The fetal distress was associated with EOP, the changes of EOP levels in umbilical artery plasma may play an important role in the pathophysiological changes in fetal distress.