新生儿分娩应激与血浆内啡肽和儿茶酚胺的关系。

M Pohjavuori, L Rovamo, T Laatikainen, V Kariniemi, J Pettersson
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引用次数: 0

摘要

11例剖宫产新生儿(A组)和18例顺产新生儿(B组)脐带血浆内啡肽和儿茶酚胺水平与脐带血气体分析值及血流动力学参数相关。所有婴儿的情况都很好。A组和B组脐带血浆肾上腺素(A)、去甲肾上腺素(NA)和免疫反应性β -内啡肽(ir β -e)平均水平差异无统计学意义。B组自然分娩后,血浆NA水平与pH呈极显著负相关,NA与脐带动脉血二氧化碳浓度呈正相关,NA与产前胎儿心率短期变异性呈正相关。脐带血浆A和ir β - e没有显示出这种相关性。这些发现表明脐带血浆NA水平是正常分娩时轻微应激的敏感指标。出生后,在出生后的前两个小时,B组阴道分娩后的平均血浆ir β - e水平下降,但在a组择期剖宫产后仍保持较高水平。这表明分娩方式影响新生儿内啡肽分泌。
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Stress of delivery and plasma endorphins and catecholamines in the newborn infant.

Cord plasma levels of endorphins and catecholamines were correlated with the values of cord blood gas analysis and with hemodynamic parameters in 11 newborns (group A) delivered by elective cesarean section and in 18 newborns (group B) born spontaneously by vaginal route. All infants were in a good condition. No statistically significant differences were found in the mean cord plasma levels of adrenaline (A), noradrenaline (NA) and immunoreactive beta-endorphin (ir beta-E) between groups A and B. After spontaneous labor in group B a highly significant negative correlation was found between plasma NA level and pH and a positive correlation between NA and carbon dioxide tension in cord arterial blood and between NA and the short-term variability of the fetal heart rate before birth. Cord plasma A and ir beta-E did not show such correlations. These findings show that cord plasma level of NA is a sensitive indicator of minor stress during normal labor. After birth, during the first two hours of life, the mean plasma level of ir beta-E decreased in group B after vaginal delivery, but remained at a higher level in group A after elective cesarean section. This shows that the mode of delivery influences the neonatal endorphin secretion.

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