早产儿和足月儿脐血及母亲静脉血硒含量的比较

Comparison of maternal and umbilical cord blood selenium levels in term and preterm infants

摘要:

目的：硒是一种人体必需的微量元素，在细胞抗氧化防御系统中发挥着主要的作用。在早期早产儿中，低水平的硒会增加诸如慢性新生儿肺疾病、早产儿视网膜病等并发症的发生。该研究旨在检测并比较早产儿和足月儿脐血及母亲静脉血硒含量。方法：选取2008年3~7月间30个足月儿（胎龄>37 周）和30个早产儿（胎龄< 34 周）及他们的母亲作为研究对象。用原子吸收光谱法测定脐血和母亲静脉血的硒含量。结果：足月儿的脐血硒平均含量高于早产儿，差异有非常显著性(124.80± 13.72 μg/L vs 100.30 ± 11.72 μg/L, P=0.0001) 。 足月儿母亲与早产儿母亲的的平均硒含量差异无显著性 (117.03±17.15 μg/L vs 110.56±17.49 μg/L, P=0.15)。将所有婴儿的资料一起分析时，发现脐血硒含量与胎龄和出生体重显著正相关(r=0.66, P<0.0001；r=0.59, P<0.0001)。60例婴儿母亲中，无一例的血硒含量低于正常参考值的下限（70.0 μg/L）。将所有婴儿及其母亲的资料一起分析时，发现母亲血硒含量与其婴儿脐血硒含量呈显著正相关 (r=0.40, P<0.001)。结论：在伊斯法罕地区，孕母的血硒水平处于一个良好的状态，血硒水平不是早产的预测指标。足月儿的脐血硒含量高于早产儿，但足月儿和早产儿的脐血硒含量均在正常参考范围。［中国当代儿科杂志，2009，11（7）：513-516］

Abstract:

OBJECTIVE: Selenium is an essential trace element and has a main role in cellular antioxidant defense system. In very preterm babies, low selenium is associated with an increased risk of complications such as chronic neonatal lung disease and retinopathy of prematurity. This study was designed to determine and compare maternal and umbilical cord blood selenium levels in term and preterm infants. METHODS: From February 2008 to April 2008, 30 term (gestational age >37 weeks) and 30 preterm infants (gestational age<34 weeks) and their mothers were enrolled. Selenium concentrations in umbilical cord and maternal venous blood were measured by atomic absorption spectrometry. RESULTS: The mean selenium concentration in term infants was higher than in preterm infants (124.80±13.72 μg/L vs 100.30±11.72 μg/L, P=0.0001). The mean selenium concentration in mothers of term and preterm infants was not significantly different (117.03±17.15 μg/L vs 110.56±17.49 μg/L, P=0.15). Cord selenium concentrations were strongly correlated with gestational age and birth weight (r=0.66, P<0.0001 and r=0.59, P<0.0001, respectively) when the data of all infants were analyzed together. None of the 60 women had a serum selenium level below the laboratory lower limit of normal (70.0 μg/L). Maternal selenium levels were correlated with cord selenium levels in their infants (r=0.40, P<0.001) when data of all newborn infants and mothers were considered together. CONCLUSIONS: Mothers have a relatively good selenium status and serum selenium is not a significant predictor of preterm delivery in Isfahan. The cord selenium concentration in term infants is significantly higher than in preterm infants, but the cord selenium concentrations in both groups are in a suggested normal range.［Chin J Contemp Pediatr, 2009, 11 (7):513-516］