【作者】 庄桂英；

【导师】 肖昕；

【作者基本信息】 暨南大学 ， 儿科学， 2009， 硕士

【摘要】 目的测定不同孕周正常妊娠及妊娠高血压疾病（hypertensive disorder complicatingpregnancy,HDCP）孕妇外周血及其分娩新生儿脐血、尿液中8-iso-PGF₂。水平,探讨正常妊娠孕妇脂质过氧化作用随妊娠进展的变化;HDCP对母儿的脂质过氧化作用;分析孕妇及其新生儿脐血、尿液中8-iso-PGF_2α水平的相关性,探讨通过测定尿液中8-iso-PGF_2α水平来反映体内脂质过氧化作用的可能性;并试图建立正常新生儿脐血、尿液中8-iso-PGF_2α水平正常参考值范围。方法研究对象为2007年12月至2009年2月在暨南大学附属第一医院正规产检及分娩的孕妇,选择正常妊娠孕妇及其分娩新生儿102对为A组,根据HDCP诊断标准,选择HDCP轻度子痫前期母亲及其分娩新生儿58对归入B组,各组据不同孕周(20w～27⁺⁶w,28w～36⁺⁶w,≥37w)分为孕中、晚期、孕足月组:即A1、A2、A3组;B1、B2、B3组。采用ELISA法测定各组中孕妇外周血和新生儿脐血血浆及尿液中8-iso-PGF_2α水平。结果1.正常妊娠孕妇血浆8-iso-PGF_2α水平随妊娠进展渐有增高,但差异无统计学意义（P=0.167）。2.HDCP轻度子痫前期孕妇血浆8-iso-PGF_2α水平随妊娠进展渐有增高,但差异无统计学意义（P=0.511）;其中各组与正常妊娠各组孕妇血浆8-iso-PGF_2α水平相比较均增高,且差异具有统计学意义（P=0.044、P=0.020、P=0.038）。3.HDCP轻度子痫前期孕妇分娩新生儿脐血8-iso-PGF_2α水平较正常妊娠孕妇分娩组高,差异具有统计学意义（P=0.007）,其中正常妊娠孕妇分娩新生儿脐血8-iso-PGF_2α水平95%可信区间为:（106.89～152.35）pg/ml。4.HDCP轻度子痫前期孕妇分娩新生儿尿液8-iso-PGF2α水平较正常妊娠孕妇分娩组高,差异具有统计学意义（P=0.000）,其中正常妊娠孕妇分娩新生儿尿液8-iso-PGF_2α水平95%可信区间为:（26.54～34.25）pg/ml。5.两组孕妇血浆与其分娩新生儿脐血8-iso-PGF_2α水平呈正相关（r=0.558,p=0.000）,新生儿脐血及尿液中8-iso-PGF_2α水平亦成正相关（r=0.448,p=0.000）。结论1.正常妊娠孕妇体内脂质过氧化作用。2.脂质过氧化参与HDCP病理生理过程,可导致孕妇及其分娩新生儿脂质过氧化损伤。3.测定孕妇血浆8-iso-PGF_2α水平可以早期预测胎儿/新生儿脂质过氧化损伤;通过测定尿液8-iso-PGF_2α水平可反映体内脂质过氧化作用。4.正常妊娠孕妇分娩新生儿脐血中8-iso-PGF_2α水平正常参考范围为（106.89～152.35）pg/ml;正常妊娠孕妇分娩新生儿尿液中8-iso-PGF_2α水平正常参考范围为（26.54～34.25）pg/ml。更多还原

【Abstract】 Objective To explore the changes of lipid peroxidation（LPO）of normal pregnant women in different gestational stages,and the influence of hypertensive disorder complicating pregnancy （HDCP）on LPO in mothers and neonates by investigating the level of 8-iso-PGF_2α in maternal peripheral blood,neonatal umbilical blood and neonatal urine of normal and hypertensive disorder complicating pregnancies and their neonates in different gestational stages,to explore the predicting value of urine 8-iso-PGF_2α on LPO by analyzing the correlationship of 8-iso-PGF_2αlevels between mothers and their newborns,and want to establish the normal range of the level of 8-iso-PGF_2α in neonatal umbilical blood and neonatal urine of the normai neonates.Methods All pregnant women recruited in this study were regularly performed perinatal care in the 1st Affiliated Hospital of Jinan University.102 pairs of normal pregnant women and their newborns were enrolled as A group,which was divided into group A₁,A₂,A₃ by gestational stages (20w～27⁺⁶w,28w～36⁺⁶w,≥37w).58 pairs of mothers with mild preeclampsia and their newborns were enrolled as B group,which was divided into group B₁,B₂,B₃ aslo by gestational stages which is the same with group A.Maternal peripheral blood,neonatal umbilical blood and neonatal urine were collected for 8-iso-PGF_2α measurement by ELISA.Results1.Maternal plasmic 8-iso-PGF_2α levels in group A had no significant difference among three gestational stages（P=0.167）.2.Maternal plasmic 8-iso-PGF_2α levels in group B had no significant difference among three gestational stages（P=0.511）.but significantly higher than that in group A（P=0.044、P=0.020、P-0.038）.3.Umbilical blood 8-iso-PGF_2α levels in groupB were significantly higher than that in group A （P=0.007）.And 95%Confidence Interval for Mean of umbilical blood 8-iso-PGF_2α levels in group A is（106.89～152.35）pg/ml。4.Neonatal urine 8-iso-PGF_2α levels in in group B were significantly higher than that in group A （P=0.000）.And 95%Confidence Interval for Mean of neonatal urine 8-iso-PGF_2α levels in group A is（26.54～34.25） pg/ml。5.There was positive correlation of 8-iso-PGF_2α levels between maternal peripheral blood and neonatal umbilical blood（r=0.558,P=0.000）.and there was also positive correlation of 8-iso-PGF_2α levels between neonatal umbilical blood and neonatal urine（r=0.448,P=0.000）.Conclusion1.LPO participate in nornal pregnancy.2.LPO may participate in pathophysiological process of HDCP and may impairment both in mothers and neonates.3.Maternal 8-iso-PGF_2α detection could be an early predictor for fetal/neonatal lipid peroxidational impairment.4.the normal range of the level of 8-iso-PGF_2αin neonatal umbilical blood of the normai neonates is（106.89～152.35）pg/ml and the normal range of the level of 8-iso-PGF_2α in neonatal urine of the normal neonates is（26.54～34.25）pg/ml.更多还原