摘要
目的探讨窒息对新生儿血清褪黑素(MT)、褪黑素受体(MR-1 mRNA)、糖皮质激素(GC)、糖皮质激素受体(GR-αmRNA)水平的影响及意义。方法收集2015年1月至2017年12月丽水市妇幼保健院收治的足月窒息新生儿90例为研究对象,将其分为轻度窒息组(Apgar评分为4~7分,n=41)和重度窒息组(Apgar评分为0~3分,n=49),且选择同期在院分娩的40例非窒息健康足月新生儿为对照组。采集新生儿出生24h内和第7天时的外周血,分离血清和单个核细胞。采用酶联免疫吸附试验检测血清中GC和MT的浓度;采用实时定量聚合酶链式反应(PCR)技术检测单个核细胞中MR-1 mRNA和GR-αmRNA的表达情况,并对结果进行分析。结果对照组出生24h内与出生第7天血清GC、MT、GR-αmRNA、MR-1 mRNA的表达水平差异均无统计学意义(均P>0.05);轻度窒息组出生第7天与出生24h内比较,血清GC、GR-αmRNA水平显著下降(t值分别为22.155、22.312),血清MT、MR-1 mRNA水平显著上升(t值分别为-42.194、-11.233),差异均有统计学意义(均P<0.05);重度窒息组出生第7天与出生24h内比较,血清GC水平显著降低(t=15.560),MT、GR-αmRNA和MR-1 mRNA水平显著升高(t值分别为-61.768,-43.211,-22.896),差异均有统计学意义(均P<0.05)。结论窒息使新生儿机体下丘脑-垂体-肾上腺皮质(HPA)轴激活,重度窒息使HPA轴发生紊乱。MT和MR-1 mRNA可能通过调节HPA轴发挥抗应激作用,未来需要进一步进行机制研究。
Objective To investigate the effects of asphyxia on levels of melatonin(MT),melatonin receptor(MR-1 mRNA),glucocorticoid(GC),glucocorticoid receptor(GR-α mRNA) in neonatal serum.Methods From January 2015 to December 2017,90 cases of full-term newborn with asphyxia in Lishui Maternal and Child Health Care Hospital were included.According to Apgar scores,90 neonates were divided into mild asphyxia group(Apgar scores ranging 4-7,n=41) and severe asphyxia group(Apgar scores ranging 0-3,n=49).In addition,40 non-asphyxia healthy full-term neonates who delivered in the hospital at the same time were collected as the control group.Plasma and mononuclear cells which were isolated from peripheral blood collected within 24 h and 7 d after birth.Then the concentrations of GC and MT in plasma were detected by enzyme-linked immunosorbent assay(ELISA),and the expressions of MR-1 mRNA and GR-α mRNA in mononuclear cells were detected by real-time quantitative polymerase chain reaction(PCR).Results There was no significant difference in the levels of serum GC,MT,GR-α mRNA and MR-1 mRNA between the 7 th day of birth and the 24 h after birth in the control group(all P>0.05).In the mild asphyxia group,the levels of serum GC and GR-α mRNA of 7 th day of birth were significantly decreased(t values were 22.155 and 22.312,respectively,both P<0.05),and the levels of serum MT and MR-1 mRNA of 7 th day of birth were significantly increased(t values were-42.194 and-11.233,respectively,both P<0.05).The levels of serum GC in severe asphyxia group decreased significantly on the 7 th day of birth(t=15.560,P<0.05),while the levels of MT,GR-alpha and MR-1 mRNA increased significantly(t values were-61.768,-43.211 and-22.896,respectively,all P<0.05).Conclusion The hypothalamic-pituitary-adrenal cortex(HPA) axis is activated by asphyxia,and the HPA axis is disordered by severe asphyxia.MT and MR-1 mRNA might play an anti-stress role by regulating the HPA axis,and further mechanism studies are needed in the future.
作者
李军胜
刘丽芳
LI Junsheng;LIU Lifang(Department of Neonatology,Lishui Maternal and Child Health Care Hospital,Lishui 323000,Zhejiang,China;Department of Child Health Care,Lishui Maternal and Child Health Care Hospital,Lishui 323000,Zhejiang,China)
出处
《中国妇幼健康研究》
2019年第10期1258-1262,共5页
Chinese Journal of Woman and Child Health Research
