羊水中兴奋性氨基酸的临床意义研究

目的:探讨羊水中兴奋性氨基酸(EAAs):天门冬氨酸(Asp)、谷氨酸(Glu)与胎儿畸形及围产儿缺氧的关系。方法:采用高效液相法对201例孕产妇进行羊水中EAAs:Asp、Glu检测。将其分为正常妊娠组137例,胎儿宫内缺氧组48例,胎儿畸形组16例。结果:①羊水中EAAs:Asp、Glu水平在正常妊娠组孕14～27+6周时分别为8 .66±3 .56μg/ml、2 .25±1 .48μg/ml,至妊娠晚期(37～41+6周)时分别为14. 81±8 .54μg/ml、12 .26±4 .08μg/ml,随孕周增加呈上升趋势(P<0. 05);②正常妊娠组羊水中EAAs:Asp、Glu水平分别为13. 45±5. 74μg/ml、8 .31±2 .09μg/ml,胎儿宫内缺氧组分别为58 .83±11 .21μg/ml、16. 75±4 .08μg/ml,胎儿畸形组分别为97 .40±13 .68μg/ml、22 .88±10 .01μg/ml,胎儿宫内缺氧组与胎儿畸形组羊水EAAs水平明显高于正常妊娠组(P<0 .01),胎儿畸形组亦明显高于胎儿宫内缺氧组(P<0 .05)。结论:正常妊娠羊水中存在EAAs:Asp、Glu,且随妊娠进展而增加;胎儿畸形、胎儿宫内缺氧时羊水中EAAs:Asp、Glu水平升高,提示羊水中EAAs:Asp、Glu检测可望成为判断胎儿畸形、胎儿宫内缺氧状况的一项敏感而简单的生化指标。

Clinical significance of excitatory amino acids in amniotic fluid

Objective:To explore relationship between excitatory amino acids in amniotic fluid, that is, asparticacid (Asp), glutamic acid (Glu), and fetal abnormality and perinatal hypoxia.Methods:201 pregnant and lying-in women determined on Asp and Glu levels in amniotic fluid of with high performance liquid chromatography (HPLC) were divided into normal pregnant group ( n =137), intrauterine fetal anoxia group ( n =48) and fetal abnormality group ( n =16).Results:①Asp and Glu levels in normal pregnant group at 14~27th+6 week of gestation were 8.66±3.56μg/ml, 2.25±1.48μg/ml, respectively; those at 37~41st+6 week of gestation were 14.81±8.54μg/ml, 12.26±4.08μg/ml, respectively. There was increasing trend with increase of gestational weeks ( P <0.05). ②Asp and Glu levels in normal control group were 13.45±5.74μg/ml, 8.31±2.09μg/ml; those in intrauterine fetal anoxia group were 58.83±11.21μg/ml, 16.75±4.08 μg/ml; those in fetal abnormality group were 97.40±13.68μg/ml, 22.88±10.01μg/ml, respectively. EAAs levels in amino acids of intrauterine fetal anoxia group and fetal abnormality group were significantly higher than those of normal pregnant group ( P <0.01); those of fetal abnormality group were obviously higher than those of intrauterine fetal anoxia group ( P <0.05).Conclusion:Asp and Glu exist in amino acids of normal pregnancy and increase with progress of gestation. But Asp and Glu levels increase in amino acids of fetal abnormality and intrauterine fetal anoxia, which suggested Asp and Glu determination could be as a sensitive and simple biochemical index of fetal abnormality and intrauterine fetal anoxia.