摘要
目的观察宫外发育迟缓(EUGR)早产儿血游离肉碱水平及胰岛素抵抗指数(InRI),并分析其相关性。方法早产儿100例,根据纠正胎龄40周时的体质量曲线,分为EUGR早产儿组和非EUGR早产儿组,同期选取足月适于胎龄儿30例作为健康对照组。各组出生后第3天及纠正胎龄40周时采集足跟血,采用API 3200串联质谱仪检测血游离肉碱水平。各组出生后第3天及纠正胎龄40周时采集股静脉血,测算InRI及单核细胞趋化蛋白-1(MCP-1)、巨噬细胞炎性蛋白-1α(MIP-1α)水平,Pearson相关分析法分析EUGR早产儿血游离肉碱水平与InRI、MCP-1、MIP-1α水平的相关性。结果EUGR早产儿组出生后第3天、纠正胎龄40周时血游离肉碱水平分别为(32.67±10.75)、(40.25±15.82)μmol/L,非EUGR早产儿组分别为(35.05±20.15)、(54.17±18.35)μmol/L,健康对照组分别为(48.05±16.58)、(50.72±36.05)μmol/L,同一时间点血游离肉碱水平组间相比,P均<0.05。EUGR早产儿组出生后第3天、纠正胎龄40周时InRI分别为0.38±0.04、0.65±0.03,MCP-1分别为(122.13±57.18)、(450.13±37.05)pg/mL,MIP-1α分别为(63.60±31.65)、(275.24±28.52)pg/mL;非EUGR早产儿组InRI分别为0.35±0.02、0.31±0.04,MCP-1分别为(118.55±37.28)、(105.73±49.22)pg/mL,MIP-1α分别为(70.52±27.48)、(82.05±18.56)pg/mL;健康对照组InRI分别为0.29±0.05、0.28±0.03,MCP-1分别为(75.08±54.15)、(80.52±34.05)pg/mL,MIP-1α分别为(80.93±24.35)、(81.05±54.05)pg/mL;其中,EUGR早产儿组出生后第3天、纠正胎龄40周时InRI、MCP-1、MIP-1α与健康对照组相比,P均<0.05;EUGR早产儿组纠正胎龄40周时InRI、MCP-1、MIP-1α与非EUGR早产儿组相比,P均<0.05;非EUGR早产儿组出生后第3天InRI、MCP-1、MIP-1α与健康对照组相比,P均<0.05;非EUGR早产儿组纠正胎龄40周时MCP-1与健康对照组相比,P<0.05。EUGR早产儿血游离肉碱水平与InRI、MCP-1、MIP-1α呈负相关关系(r分别为-0.59、-0.72、-0.51,P均<0.05)。结论EUGR早产儿出生后第3天、纠正胎龄40周时血游离肉碱水平降低、InRI升高,两者呈负相关关系。
Objective To observe the blood free carnitine and insulin resistance index in preterm newborns of extrau-terine growth retardation(EUGR)and to analyze the correlations between them.Methods One hundred preterm newbo rns were divided into the EUGR group(32 preterm newborns with EUGR)and non-EUGR group(68 preterm newborns without EUGR)according to the Feton intrauterine growth curve values,meanwhile,30 cases of term newborns were select ed as the control group.Heel blood was collected on the 3rd day after birth and at 40 weeks of corrected gestational age.We used API 3200 tandem mass spectrometer to measure blood free carnitine levels.On the 3rd day after birth and at 40 weeks of corrected gestational age,we collected the femoral vein blood and calculated the insulin resistance index(InRI),monocyte chemotactic protein-1(MCP-1),and macrophage inflammatory protein-1 a(MIP-1a)levels,and the correlation between blood free carnitine levels and InRI,MCP-1,MIP-1 a levels in preterm infants of EUGR was analyzed by Pearson correlation analysis.Results On the 3rd day after birth and at 40 weeks of corrected gestational age,the concentrations of free carnitine were(32.67±10.75)and(40.25±15.82)μmoL/L,respectively,in the EUGR group,(35.05±20.15)and(54.17±18.35)μmol/L,respectively,in the non-EUGR group,and(48.05±16.58)and(50.72±36.05)μmol/L,respectively,in the control group,with statistically significant differences between every two groups(all P<0.05).On the 3rd day after birth and at 40 weeks of corrected gestational age,the InRI in the EUGR group were 0.38±0.04 and 0.65±0.03,respectively,the levels of MCP-1 were(122.13±57.18)and(450.13±37.05)pg/mL,respectively,and the levels of MIP-1 a were(63.60±31.65)and(275.24±28.52)pg/mL,respectively;the InRI in the non-EUGR group were 0.35±0.02 and 0.31±0.04,respectively,the levels of MCP-1 were(118.55±37.28)and(105.73±49.22)pg/mL,respectively,and the levels of MIP-1 a were(70.52±27.48)and(82.05±18.56)pg/mL,respectively,with significant differences in the InRI,MCP-1,and MIP-1 a(all P<0.05).The concentration of carnitine in the EUGR infants was negatively correlated with InRI,MCP-1,and MIP-1 a(r=-0.59,-0.72,-0.51,all P<0.05).Conclusion On the 3rd day after birth and at 40 weeks of corrected gestational age,the blood free carnitine level of EUGR preterm infants decreases,and InRI increases,and there is a negative correlation between them.
作者
刘艳明
LIU Yanming(The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)
出处
《山东医药》
CAS
2019年第36期13-16,共4页
Shandong Medical Journal
基金
广西医疗卫生适宜技术开发与推广应用项目(S2018055)
关键词
肉碱
胰岛素抵抗指数
早产儿
宫外发育迟缓早产儿
carnitine
insulin resistance index
preterm newborns
extrauterine growth restriction in preterm infants
