目的 分析脐血中丙二醛(MDA)、晚期氧化蛋白产物(AOPP)表达水平与胎儿窘迫及不良结局的相关性,为预防胎儿窘迫提供依据。方法 选取2016年8月—2018年8月石家庄市妇产医院收治的134例急性胎儿窘迫新生儿作为研究组,120例正常新生儿作为对照组。待胎儿娩出后立即采集脐动脉血检测MDA和AOPP水平。采用Pearson分析脐动脉血MDA、AOPP水平与胎儿窘迫发生情况、胎儿窘迫持续时间及新生儿1 min Apgar评分和不良妊娠结局的相关性。结果 研究组新生儿脐动脉血MDA和AOPP水平显著高于对照组(t=18.481、14.501,P＜0.05),胎儿窘迫持续时间≤30 min组、＞30 min组与对照组脐动脉血MDA和AOPP水平比较,差异有统计学意义(F=499.522、185.460,P＜0.05),随着胎儿窘迫时间延长,新生儿脐动脉血MDA和AOPP水平显著增加(F=777.902、234.601,P＜0.05)。1 min Apgar评分0～3分、4～7分和8～10分新生儿动脉血MDA和AOPP水平比较,差异有统计学意义(P＜0.05),0～3分组最高,8～10分组最低。Pearson分析表明新生儿脐动脉血MDA和AOPP与胎儿窘迫发生、胎儿窘迫持续时间呈显著正相关(r=0.792、0.819,0.835、0.867,P＜0.01),与新生儿1 min Apgar评分呈显著负相关(r=-0.796、-0.763,P＜0.01)。分娩后发生吸入性肺炎、缺血缺氧性脑病、新生儿窒息和死亡的新生儿脐动脉血MDA和AOPP水平显著高于未发生相应不良结局新生儿(P＜0.05)。结论 脐动脉血MDA和AOPP水平与胎儿窘迫密切相关,其水平能够反映胎儿窘迫持续时间和程度。

Objective To analyze the relationship between malondialdehyde (MDA) and advanced oxidation protein product (AOPP) expression in fetal cord blood and fetal distress as well as adverse outcomes,so as to provide basis for the prevention of fetal distress. Methods A total of 134 neonates with acute fetal distress in Shijiazhuang Maternity Hospital were selected as study group from August 2016 to August 2018,and 120 normal neonates were selected as control group.Umbilical arterial blood was collected immediately after delivery of the fetus to detect MDA and AOPP levels.Pearson analysis was used to analyze the correlation between umbilical arterial blood MDA,AOPP level and fetal distress,fetal distress duration,neonatal 1 min Apgar score and adverse pregnancy outcome. Results The levels of MDA and AOPP in the umbilical arterial blood of study group were significantly higher than those in control group (t=18.481,14.501,P<0.05).There were significant differences on the levels of MDA and AOPP in neonatal umbilical artery blood among control group,fetal distress duration group ≤30 min and the group>30 min (F=499.522,185.460,P＜0.05).The MDA and AOPP levels of new umbilical arterial blood increased significantly with the prolongation of fetal distress (P＜0.05).Compared with 0-3,4-7 and 8-10 at 1 min Apgar score,the levels of MDA and AOPP in neonatal arterial blood were statistically significant (F=777.902,234.601,P<0.05),with the highest score in group 0～3 and the lowest in group 8～10.Pearson analysis indicated that MDA and AOPP in neonatal umbilical arterial blood were significantly positively correlated with fetal distress and fetal distress duration(r=0.792,0.819,0.835,0.867,P＜0.01),and negatively related to neonatal 1 min Apgar score (r=-0.796,-0.763,P＜0.01).The levels of MDA and AOPP in umbilical arterial blood of neonates with aspiration pneumonia,hypoxic ischemic encephalopathy,neonatal asphyxia and death after delivery were significantly higher than those without corresponding adverse outcomes (P＜0.05). Conclusion MDA and AOPP levels in umbilical arterial blood are closely related to fetal distress,which can reflect the duration and extent of fetal distress.