CAJ | 학술논문

目的：探究新生儿免疫功能及围产期高危感染、分娩方式与胎龄的关系，为临床围产期感染预防提供依据。方法选取2011年1月－2014年1月单胎分娩的孕产妇1600例，根据围产期是否有高危感染因素分为高危组和对照组，根据分娩方式不同分为剖宫产组和阴道产组，根据是否早产分为早产组和非早产组，测定并比较新生儿脐带血中免疫球蛋白IgA、IgG、IgM 和补体C3、C4的水平。结果高危组的IgA、IgM 的水平高于对照组，差异有统计学意义（P＜0．05）；而高危组的IgG水平与非对照组的差异无统计学意义；补体C3、C4水平的比较，高危组的C3水平显著低于对照组，差异有统计学意义（P＜0．05）；高危组C4水平与对照组差异无统计学意义；阴道产组的新生儿IgG水平高于剖宫产组的新生儿，比较差异有统计学意义（P＜0．05）；而阴道产组的IgA、IgM及补体C3、C4和剖宫产组差异均无统计学意义；早产组与非早产组IgA、IgM 差异均无统计学意义；而早产组IgG水平显著低于非早产组，差异有统计学意义（P＜0．05）；早产组补体C3、C4水平均低于非早产组，比较差异有统计学意义（P＜0．05）。结论围产期感染高危因素与新生儿感染密切相关，分娩方式对新生儿免疫功能基本无影响，胎龄不足的新生儿免疫功能发育不足。
목적：탐구신생인면역공능급위산기고위감염、분면방식여태령적관계，위림상위산기감염예방제공의거。방법선취2011년1월－2014년1월단태분면적잉산부1600례，근거위산기시부유고위감염인소분위고위조화대조조，근거분면방식불동분위부궁산조화음도산조，근거시부조산분위조산조화비조산조，측정병비교신생인제대혈중면역구단백IgA、IgG、IgM 화보체C3、C4적수평。결과고위조적IgA、IgM 적수평고우대조조，차이유통계학의의（P＜0．05）；이고위조적IgG수평여비대조조적차이무통계학의의；보체C3、C4수평적비교，고위조적C3수평현저저우대조조，차이유통계학의의（P＜0．05）；고위조C4수평여대조조차이무통계학의의；음도산조적신생인IgG수평고우부궁산조적신생인，비교차이유통계학의의（P＜0．05）；이음도산조적IgA、IgM급보체C3、C4화부궁산조차이균무통계학의의；조산조여비조산조IgA、IgM 차이균무통계학의의；이조산조IgG수평현저저우비조산조，차이유통계학의의（P＜0．05）；조산조보체C3、C4수평균저우비조산조，비교차이유통계학의의（P＜0．05）。결론위산기감염고위인소여신생인감염밀절상관，분면방식대신생인면역공능기본무영향，태령불족적신생인면역공능발육불족。
OBJECTIVE To explore the relationship between the immune function of the neonates and the perinatal infections ,delivery mode ,and gestational age so as to provide guidance for clinical prevention of the perinatal in‐fections .METHODS A total of 1 600 pregnant and parturient women who gave single birth from Jan 2011 to Jan 2014 were enrolled in the study and divided into the high risk group and the control group according to the high risk factors for the perinatal infections ,the participants were divided into the cesarean section group and the vagi‐nal delivery group according to the delivery mode and were divided into the premature delivery group and the non‐premature delivery group according to status of premature birth .The levels of immunoglobulin A (IgA) ,immuno‐globulin G (IgG) ,immunoglobulin M (IgM ) ,complement C3 ,and complement C4 in the umbilical cord blood of the neonates were determined and compared .RESULTS The levels of the IgA and IgM of the high risk group were higher than those of the control group ,there was significant difference (P<0 .05);there was no significant differ‐ence in the level of IgG between the high risk group and the non‐control groups .As compared with the levels of C3 and C4 ,the level of C3 of the high risk group was significantly lower than that of the control group(P<0 .05);there was no significant difference in the level of C4 between the high risk group and the control group .The level of IgG of the neonates was significantly higher in the vaginal delivery group than in the cesarean section group(P<0 .05) ,however ,there was no significant difference in the level of IgA ,IgM ,C3 or C4 between the vaginal deliv‐ery group and the cesarean section group .There was no significant difference in the level of IgA or IgM between the premature delivery group and the non‐premature delivery group;the level of IgG of the premature delivery group was significantly lower than that of the non‐premature delivery group(P<0 .05) .The levels of both C3 and C4 of the premature delivery group were significantly lower than those of the non‐premature delivery group(P<0 .05) .CONCLUSION The neonatal infections are closely associated with the high risk factors for the perinatal in‐fections ,the delivery mode shows little effect on the immune function of the neonates ,and the neonates with inad‐equate gestational age have the immune function hypoplasia .