新生儿血17-羟孕酮的正常水平及其影响因素
신생인혈17-간잉동적정상수평급기영향인소
Peripheral blood level of 17-hydroxyprogesterone in neonates and influencing factors
  • 万方数据
    中华围产医学杂志 중화위산의학잡지
    Chinese Journal of Perinatal Medicine
    2015年 9期 687-691 ,共5页

    苏跃青%朱文斌%王旌%周进福%赵红%陈瑶%曾颖琳%张洪华%林枫

    소약청%주문빈%왕정%주진복%조홍%진요%증영림%장홍화%림풍

    17-羟孕酮%肾上腺增生,先天性%婴儿,新生 17-羥孕酮%腎上腺增生,先天性%嬰兒,新生
    17-간잉동%신상선증생,선천성%영인,신생
    17-Hydroxyprogesterone%Adrenal hyperplasia,congenital%Infant,newborn
    目的 探讨新生儿末梢血17-羟孕酮的水平及影响因素. 方法 2012年11月1日至2014年1月31日,在福建省妇幼保健院分娩的新生儿中,排除先天性肾上腺皮质增生症患儿,共18 461例纳入本研究.新生儿出生后72 h后采集末梢血,采用时间分辨荧光免疫分析法检测17-羟孕酮水平.根据不同性别、分娩方式、胎龄、出生体重、胎数、采血时日龄、是否住院治疗分组;18 461例中,2 997例因各种原因住院治疗,根据其全血血糖水平、酸碱平衡状况以及是否电解质紊乱分组;比较各组间17-羟孕酮水平.17-羟孕酮水平采用几何均数(95％CI)表示,采用Mann-Whitney U检验、Kruskal-WallisH检验、多元线性回归进行统计学分析. 结果 18 461例新生儿的17-羟孕酮水平为0.0～196.0 nmol/L,几何均数为5.7 (5.6～5.8) nmol/L;男性(n=10 026)与女性(n-8 435)分别为6.1(6.0～6.2)与5.4 (5.2～5.5) nmol/L;剖宫产(n=7 014)与阴道分娩者(n=11 447)分别为6.2(6.0～6.3)与5.5 (5.4～5.6) nmol/L;多胎妊娠(n=656)与单胎妊娠者(n=17 805)分别为8.7(8.2～9.3)与5.6 (5.6～5.7) nmol/L;住院治疗(n=2 997)与未住院治疗者(n=15 464)分别为8.0(7.7～8.4)与5.4 (5.3～5.5) nmol/L.男性、剖宫产、多胎及住院治疗者的血17-羟孕酮水平较高(Z值分别为-10.65、-10.88、-14.21和-27.63,P值均≤0.05).分别比较8组不同胎龄、7组不同出生体重和5组不同采血时日龄的新生儿17-羟孕酮水平,差异均有统计学意义(x2值分别为2 409.25、1 510.30与636.60,P值均≤0.05).进一步两两比较,胎龄≥29周新生儿的17-羟孕酮水平随胎龄增加呈下降趋势;出生体重≤4 000 g新生儿的17-羟孕酮水平随出生体重增加呈下降趋势;采血时日龄3、4和5d组的17-羟孕酮水平呈下降趋势.2 997例住院新生儿中,酸碱失衡组与平衡组的17-羟孕酮水平的几何均数分别为9.7(8.6～10.8)与7.0(6.3～7.7) nmol/L,电解质紊乱组和电解质正常组分别为9.4(8.5～10.3)与7.9 (7.5～8.3) nmol/L,酸碱失衡组和电解质紊乱组均较高(Z值分别为-6.21和-4.49,P值均≤0.05).低血糖、正常血糖、高血糖水平的3组新生儿17-羟孕酮水平分别为9.7(9.1～10.4)、8.1(7.6～8.6)与8.6(6.7～11.1) nmol/L,低血糖组和高血糖组均高于正常血糖组(Z值分别为-4.18和-2.11,P值均＜0.05).根据R2值,前3位影响因素依次为胎龄、出生体重和血糖(R2值分别为0.200、0.115和0.080).多元线性回归分析显示,9个影响因素均进入回归方程,按作用从大到小依次为胎龄、出生体重、血糖、酸碱平衡、胎数、血电解质、分娩方式、性别和采血时日龄. 结论 新生儿末梢血17-羟孕酮水平受到胎龄、出生体重、血糖、酸碱平衡等多种因素影响.
    목적 탐토신생인말소혈17-간잉동적수평급영향인소. 방법 2012년11월1일지2014년1월31일,재복건성부유보건원분면적신생인중,배제선천성신상선피질증생증환인,공18 461례납입본연구.신생인출생후72 h후채집말소혈,채용시간분변형광면역분석법검측17-간잉동수평.근거불동성별、분면방식、태령、출생체중、태수、채혈시일령、시부주원치료분조;18 461례중,2 997례인각충원인주원치료,근거기전혈혈당수평、산감평형상황이급시부전해질문란분조;비교각조간17-간잉동수평.17-간잉동수평채용궤하균수(95％CI)표시,채용Mann-Whitney U검험、Kruskal-WallisH검험、다원선성회귀진행통계학분석. 결과 18 461례신생인적17-간잉동수평위0.0～196.0 nmol/L,궤하균수위5.7 (5.6～5.8) nmol/L;남성(n=10 026)여녀성(n-8 435)분별위6.1(6.0～6.2)여5.4 (5.2～5.5) nmol/L;부궁산(n=7 014)여음도분면자(n=11 447)분별위6.2(6.0～6.3)여5.5 (5.4～5.6) nmol/L;다태임신(n=656)여단태임신자(n=17 805)분별위8.7(8.2～9.3)여5.6 (5.6～5.7) nmol/L;주원치료(n=2 997)여미주원치료자(n=15 464)분별위8.0(7.7～8.4)여5.4 (5.3～5.5) nmol/L.남성、부궁산、다태급주원치료자적혈17-간잉동수평교고(Z치분별위-10.65、-10.88、-14.21화-27.63,P치균≤0.05).분별비교8조불동태령、7조불동출생체중화5조불동채혈시일령적신생인17-간잉동수평,차이균유통계학의의(x2치분별위2 409.25、1 510.30여636.60,P치균≤0.05).진일보량량비교,태령≥29주신생인적17-간잉동수평수태령증가정하강추세;출생체중≤4 000 g신생인적17-간잉동수평수출생체중증가정하강추세;채혈시일령3、4화5d조적17-간잉동수평정하강추세.2 997례주원신생인중,산감실형조여평형조적17-간잉동수평적궤하균수분별위9.7(8.6～10.8)여7.0(6.3～7.7) nmol/L,전해질문란조화전해질정상조분별위9.4(8.5～10.3)여7.9 (7.5～8.3) nmol/L,산감실형조화전해질문란조균교고(Z치분별위-6.21화-4.49,P치균≤0.05).저혈당、정상혈당、고혈당수평적3조신생인17-간잉동수평분별위9.7(9.1～10.4)、8.1(7.6～8.6)여8.6(6.7～11.1) nmol/L,저혈당조화고혈당조균고우정상혈당조(Z치분별위-4.18화-2.11,P치균＜0.05).근거R2치,전3위영향인소의차위태령、출생체중화혈당(R2치분별위0.200、0.115화0.080).다원선성회귀분석현시,9개영향인소균진입회귀방정,안작용종대도소의차위태령、출생체중、혈당、산감평형、태수、혈전해질、분면방식、성별화채혈시일령. 결론 신생인말소혈17-간잉동수평수도태령、출생체중、혈당、산감평형등다충인소영향.
    Objective To determine the peripheral blood level of 17-hydroxyprogesterone (17-OHP) in neonates and to analyze its influencing factors.Methods All newborns (n=18 461) born in Fujian Maternity and Child Health Care Hospital from November 1,2012 to January 31,2014 were included in this study,except for those with congenital adrenal hyperplasia.Heel prick blood samples were collected after 72 h after birth for determination of 17-OHP by time resolved fluorescence immunoassay.All subjects were grouped according to different factors such as gender,mode of delivery,gestational age,birth weight,number of pregnancies,time of blood sampling and whether to be hospitalized.While 2 997 inpatients among them were grouped according to blood glucose level,acid-base equilibrium,and levels of electrolytes,respectively.The level of 17-OHP was analyzed with Mann-Whitney U test,Kruskal-Wallis H test and multiple linear regression.Results The level of 17-OHP in these newborns ranged from 0.0 to 196.0 nmol/L with a geometric mean (GM) of 5.7 (5.6-5.8) nmol/L.The GM level was higher in male group (n=10 026) than in female group (n=8 435)[6.1 (6.0-6.2) vs 5.4 (5.2-5.5) nmol/L,Z=-10.65,P ≤ 0.05];higher in ccsarean delivery group (n=7 014) than in vaginal delivery group (n=11 447) [6.2 (6.0-6.3) vs 5.5 (5.4-5.6) nmol/L,Z=-10.88,P ≤ 0.05];higher in multiply pregnancy group (n=656) than in singleton pregnancy group (n=17 805) [8.7 (8.2-9.3) vs 5.6 (5.6-5.7) nmol/L,Z=-14.21,P ≤ 0.05];higher in inpatient treatment group (n=2 997) than in outpatient treatment group (n=15 464) [8.0 (7.7-8.4) vs 5.4 (5.3-5.5) nmol/L,Z=-27.63,P ≤ 0.05].Significant difference was found in 17-OHP level among the eight groups with different gestational age,seven groups with different birth weight and five groups with different age at sampling (x2=2 409.25,1 510.30 and 636.60,all P ≤ 0.05).Further analysis showed that the 17-OHP level deceased with the increasing birth weight (if less than 4 000 g),with the increase of gestational age (if ≥ 29 weeks),and with the growth of the babies (from day 3 after birth to day 5).Among the 2 997 inpatients,higher 17-OHP level was found in the acid-base imbalance group than in the acid-base equilibrium group [9.7 (8.6-10.8) vs 7.0 (6.3-7.7) nmol/L,Z=-6.21,P ≤ 0.05],and higher in the electrolyte disturbance group than in the electrolyte balanced group [9.4 (8.5 10.3) vs 7.9 (7.5-8.3) nmol/L,Z=-4.49,P ≤ 0.05].The 17-OHP level in the hypoglycemia and hyperglycaemia group than in the euglycemia group respectively [9.7 (9.1-10.4) and 8.1 (7.6-8.6) vs 8.6 (6.7-11.1) nmol/L,Z=-4.18and-2.11,both P ≤ 0.05].The R2 value of gestational age,birth weight and glucose were 0.200,0.115 and 0.080 respectively.Multivariate linear regression analysis showed that 17-OHP was influenced the most by gestational age,followed by birth weight,blood glucose,acid-base balance status,number of pregnancies,electrolytes,mode of delivery,gender and days on blood sampling.Conclusion The peripheral blood level of 17-OHP in neonates is affected by many factors,such as gestational age,birth weight,blood glucose and acidbase equilibrium.
    원문보기 원문다운로드 사이트로이동
저자의 최근 논문