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发育医学电子杂志  2023, Vol. 11 Issue (5): 371-376    DOI: 10.3969/j.issn.2095-5340.2023.05.008
  围产医学   论著 |新生儿 |
羊水污染与新生儿缺氧缺血性脑病以及血清Tau 蛋白、S100B 表达水平的相关研究
吕红艳 刘芳 王秋丽 董志勇 张惠明
(1. 邯郸市妇幼保健院 新生儿科,河北 邯郸 056002;2. 解放军联勤保障部队第九八〇医院 儿科,河北 石家庄050082)
Study on the correlation between amniotic fluid contamination and neonatal hypoxicischemic encephalopathy and the expression levels of serum Tau protein and S100B
Lyu Hongyan, Liu Fang, Wang Qiuli, et al
(1.Department of Neonatology,Handan Maternal and Child Health Care Hospital, Hebei, Handan 056002, China; 2. Department of Pediatrics,the 980th Hospital of the PLA Joint Logistics Support Force, Hebei, Shijiazhuang 050082, China)
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摘要 【摘要】 目的  探讨羊水污染与新生儿缺氧缺血性脑病(hypoxic-ischemic encephalopathy,HIE)以及血
清Tau 蛋白、Sl00B 表达水平的相关性。 方法 将2018 年8 月至2022 年8 月邯郸市妇幼保健院新生儿科重症监护室(neonatal intensive care unit,NICU)收治的75 例中度和重度HIE 患儿纳入HIE 组(中
度31 例,重度44 例),选择同期在产科出生的正常健康足月新生儿35 例纳入对照组。根据羊水污染
程度,将患儿分为羊水正常组以及Ⅰ度、Ⅱ度、Ⅲ度羊水污染组。比较各组羊水污染情况以及血清Tau
蛋白、S100B 表达水平。统计学方法采用t 检验、Student-Newman-Keuls 检验、χ2 检验或Fisher 确切
概率法。 结果  HIE 组母亲自然阴道分娩的比例低于对照组[36.0%(27/75 与57.1%(20/35)],HIE
组新生儿5 min Apgar 评分低于对照组[(3.5±1.4)与(8.5±1.0)分],差异均有统计学意义(P 值均<0.05)。75 例HIE 患儿中,羊水正常20 例(26.7%),Ⅰ度羊水污染13 例(17.3%),Ⅱ度羊水污染10 例(13.3%),Ⅲ度羊水污染32 例(42.7%)。重度HIE 患儿Ⅲ度羊水污染的比例高于中度HIE 患儿,差异有统计学意义[59.1%(26/44)与19.4%(6/31),P<0.05]。中、重度HIE 组患儿血清Tau 蛋白、S100B 水平明显高于对照组(P 值均<0.05);重度HIE 组患儿血清Tau 蛋白、S100B 水平明显高于中度HIE 组,差异均有统计学意义(P 值均<0.05)。羊水正常和Ⅰ度、Ⅱ度、Ⅲ度羊水污染组的HIE 患儿血清Tau 蛋白、S100B 水平均明显高于对照组,差异均有统计学意义(P 值均<0.05);Ⅲ度羊水污染HIE 组患儿血清Tau 蛋白、S100B水平明显高于羊水正常HIE 组和Ⅰ度羊水污染HIE 组患儿,差异均有统计学意义(P 值均<0.05)。  羊水污染与新生儿HIE 有密切关系,重度HIE 患儿中,Ⅲ度羊水污染的比例较高,血清Tau 蛋白、
S100B 水平也较高,脑损伤程度较严重。
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关键词:  羊水污染  新生儿缺氧缺血性脑病  血清Tau 蛋白  危险因素    
Abstract: 【Abstract】 Objective To investigate the correlation between amniotic fluid contamination and
neonatal hypoxic-ischemic encephalopathy (HIE) and the expression levels of serum Tau protein and
Sl00B. Method A total of 75 neonates with moderate to severe HIE admitted to the Neonatal Intensive
Care Unit (NICU), Handan Maternal and Child Health Care Hospital from August 2018 to August 2022 were
included in the HIE group (31 cases of moderate and 44 cases of severe). A total of 35 normal healthy full-
term newborns born in the Department of Obstetrics at the same period were included in the control group.According to the degree of amniotic fluid contamination, the children were divided into normal amnioticgroup and amniotic fluid contamination group of Ⅰ, Ⅱ and Ⅲ degrees. Amniotic fluid contamination andserum Tau protein and S100B expression levels were compared among all groups. The statistical methodsperformed by t-test, Student-Newman-Keuls test, χ2 test or Fisher exact probability method.  Result Theproportion of natural vaginal delivery in the HIE group was lower than that in the control group [36.0% (27/75)vs 57.1% (20/35)], and the 5 min Apgar score of neonates in the HIE group was lower than that in the controlgroup [(3.5±1.4) vs (8.5±1.0) points], with statistical significance (all P<0.05). Of the 75 HIE infants, 20cases (26.7%) had normal amniotic fluid, 13 cases (17.3%) had grade I amniotic fluid contamination, 10cases (13.3%) had grade Ⅱ amniotic fluid contamination, and 32 cases (42.7%) had grade Ⅲ amniotic fluidcontamination. The proportion of grade Ⅲ amniotic fluid contamination in children with severe HIE washigher than that in children with moderate HIE, and the difference was statistically significant [59.1% (26/44)vs 19.4% (6/31), P<0.05]. The levels of serum Tau protein and S100B in moderate and severe HIE groupswere significantly higher than those in the control group (P<0.05). The levels of serum Tau protein and S100Bin severe HIE group were significantly higher than those in moderate HIE group, and the differences werestatistically significant (all P<0.05). The levels of serum Tau protein and S100B in HIE group with normalamniotic fluid and amniotic fluid contamination in Ⅰ, Ⅱ and Ⅲ degrees were significantly higher than thosein the control group, and the differences were statistically significant (P<0.05). The levels of serum Tauprotein and S100B in grade Ⅲ amniotic fluid contaminated HIE group were significantly higher than those innormal amniotic fluid HIE group and grade Ⅰ amniotic fluid contaminated HIE group, and the differences werestatistically significant (all P<0.05). Conclusion Amniotic fluid contamination is closely related to neonates with HIE. Among children with severe HIE, the proportion of grade Ⅲ amniotic fluid contamination is higher, thelevels of serum Tau protein and S100B are also higher, and the degree of brain injury is more serious.
Key words:  Amniotic fluid contamination    Neonatal hypoxic-ischemic encephalopathy    Serum Tau protein    S100B    Risk factor
收稿日期:  2023-04-23                出版日期:  2023-09-30      发布日期:  2023-09-27      期的出版日期:  2023-09-30
基金资助: 河北省科技计划项目(162777201)
通讯作者:  吕红艳    E-mail:  3581479478@qq.com
引用本文:    
吕红艳 刘芳 王秋丽 董志勇 张惠明. 羊水污染与新生儿缺氧缺血性脑病以及血清Tau 蛋白、S100B 表达水平的相关研究[J]. 发育医学电子杂志, 2023, 11(5): 371-376.
Lyu Hongyan, Liu Fang, Wang Qiuli, et al. Study on the correlation between amniotic fluid contamination and neonatal hypoxicischemic encephalopathy and the expression levels of serum Tau protein and S100B. Journal of Developmental Medicine(Electronic Version), 2023, 11(5): 371-376.
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