早产儿脐血激活素A水平检测的临床意义

Measurement of umbilical activin A level in preterm infants

摘要:

目的：探讨早产儿脐血血清激活素A检测的临床意义。方法：将41例胎龄为28～36周的早产儿作为研究对象，分别留取脐带、脐血和胎膜，用ELISA方法检测脐血血清激活素A的水平，镜下观察胎膜及脐带的病理改变。结果：41例早产儿脐血血清激活素A平均水平为2069 pg/mL。5例宫内感染的患儿脐血血清激活素A水平明显高于无感染患儿（2510 pg/mL vs 1975 pg/mL, P<0.01）。脐血血清激活素A对宫内感染的诊断临界值为2490 pg/mL，敏感度为80.0%，特异度为90.6%。脐血血清激活素A的水平与生后是否发生呼吸窘迫综合征无关，但与生后氧疗时间存在正相关关系（r=0.326, P<0.05）。结论：脐血激活素A可作为反映早产儿宫内感染的指标，其水平高低与生后氧疗时间有关。

Abstract:

OBJECTIVE: To evaluate the clinical significance of umbilical activin A in preterm infants. METHODS: Forty-one preterm infants (gestation 28 to 36 weeks) were enrolled. Fetal membranes, umbilical cords and blood samples from umbilical vein were obtained. Umbilical activin A level was measured using ELISA. The histological examinations of fetal membranes and umbilical cords were performed. RESULTS: The umbilical level of activin A averaged 2069 pg/mL in the 41 preterm infants. The umbilical activin A level in the 5 infants with intrauterine infection was higher than in those without intrauterine infection (2510 pg/mL vs 1975 pg/mL; P<0.01). Umbilical activin A level at cutoff of 2490 pg/mL showed a sensitivity of 80.0% and a specificity of 90.6% as a marker of intrauterine infection. There were no significant differences in the umbilical activin A level between the infants with and without respiratory distress syndrome. Umbilical activin A level was positively correlated with the duration of postnatal oxygen therapy (r=0.326, P<0.05). CONCLUSIONS: Umbilical activin A may serve a marker of intrauterine infection in preterm infants. The umbilical activin A level is correlated with the duration of postnatal oxygen therapy.