足月小于胎龄儿脐血中HO-1测定及其与小于胎龄儿发病关系

目的:探讨HO-CO系统与小于胎龄儿(small for gestational age,SGA)发病的关系及相关机制,为SGA的病因学防治开辟新思路。方法:选择2004年11月～2006年11月间正常分娩的足月小于胎龄儿(非匀称型SGA)50例(其中母亲无妊高征为SGA1组30例,母亲患中重度妊高征为SGA2组20例),以健康足月适于胎龄儿(appropriate for gestational age,AGA)20例为对照(AGA组)。于新生儿娩出后立即采集脐动脉血标本并留取近胎盘处脐带标本,分别用双波长分光光度法测定新生儿脐血中血红素氧合酶-1(heme oxygenase-1,HO-1)的活性,用Chalmers血红蛋白结合及连二亚硫酸钠还原法测定脐血中碳氧血红蛋白(HbCO)百分含量,并通过免疫组化法观察新生儿脐血管上HO-1的表达。结果:①SGA1组及SGA2组脐血HO-1活性、HbCO百分含量均显著低于AGA组(P<0.01)。而SGA1组与SGA2组脐血HO-1活性、HbCO百分含量比较差异无统计学意义(P>0.05)。②AGA组、SGA1组及SGA2组脐血HO-1活性与新生儿出生体重均呈正相关(P<0.05)。③脐血管上HO-1的表达:SGA1组和SGA2组与AGA组比较HO-1表达强度高,差异有统计学意义(P<0.01);SGA1组与SGA2组之间比较差异无统计学意义(P>0.05)。结论:脐血HO-1活性与胎儿宫内发育及新生儿营养状况密切相关。

Correlation between detection of heme oxygenase - 1 in umbilical blood and pathogenesis of small for gestational age infants

Objective:To explore the correlation between heme oxygenase(HO)-carbon monoxide(CO) system and pathogenesis of small for gestational age infants(SGA),search for a new way in prophylaxis and treatment.Methods:50 full term SGA neonates were selected as SGA group(SGA1 group was consisted of 30 cases whose mothers without pregnancy-induced hypertension syndrome,SGA2 group was consisted of 20 cases whose mothers with middle or severe pregnancy-induced hypertension syndrome).Meanwhile,20 healthy full term appropriate for gestational age(AGA) neonates were selected as AGA group.The umbilical artery blood specimens were collected immediately after the neonates were delivered,umbilical cord specimens near placenta were kept as well.HO-1 activity in umbilical blood was detected by dual wavelength spectrophotometer.HbCO percentage in plasma of umbilical blood was detected by chalmers hemoglobin method.The expression of HO-1 in umbilical blood vessels was detected by immunohistochemistry method.Results:①HO-1 activity and HbCO percentages in the umbilical blood of SGA1 group and SGA2 group were significantly lower than those of AGA group(P<0.01),but there was no difference between SGA1 group and SGA2 group(P>0.05).②There was positive correlation between HO-1 activity in umbilical blood of AGA group,SGA1 group and SGA2 group and birth weight(P<0.05).③Expression of HO-1 in the umbilical blood of SGA1 group and SGA2 group were significantly higher than those of AGA group(P<0.01),but there was no difference between SGA1 group and SGA2 group(P>0.05).Conclusion:HO-1 activity in umbilical blood correlates closely with intrauterine growth and nutrition status of the neonates.