胎膜早破对新生儿脐血免疫球蛋白及补体的影响

目的:研究胎膜早破时新生儿脐血免疫球蛋白、补体的变化规律。方法:应用速率透射比浊法检测79例新生儿脐血IgG、IgA、IgM和补体C3、C4水平,追踪新生儿出生1周内感染发生的情况,其中有胎膜早破史的研究组38例,无胎膜早破史的对照组41例。结果:胎膜早破组脐血IgA(0.16±0.12)g/L,对照组(0.06±0.03)g/L,(P<0.01);胎膜早破组IgM(0.24±0.15)g/L,对照组(0.16±0.03)g/L,(P<0.01),差异有统计学意义;脐血IgG水平无明显变化;脐血IgA浓度在胎膜早破72h为0.234±0.156)g/L,较胎膜早破<12h的0.091±0.047g/L明显增加,差异有统计学意义(P<0.05);脐血补体C3(0.76±0.35)g/L,对照组(0.93±0.21)g/L,(P<0.05),C4(0.16±0.09)g/L,对照组0.20±0.05g/L,(P<0.05),研究组明显低于对照组,差异有统计学意义。结论:有胎膜早破史的新生儿,脐血免疫球蛋白IgA、IgM浓度升高,IgG不受胎膜早破的影响,脐血补体C3、C4水平下降。脐血IgA、IgM及补体C3、C4均能反映胎膜早破个体合并宫内感染。

The Effect of PROM on Cord Blood Immunoglobulin and Complement

Objective:Evaluating the effect of PROM on the values of cord blood immunog-lobins and complements. Methods:Used the method of immunonephelometry to detect the levelsof immuglobins and compliments, and to pursue the incident of neonatal inflammation within oneweek after birth. Results:When compared to normal control subjects, the cord blood concentrationsof IgA (P<0.01) and IgM (P<0.01) in the patients with PROM were significantly elevated. There was no difference in cord blood level IgG (P>0.05) between the patients with PROM and withoutPROM. Among the patients with PROM, the cord blood concentrations of IgA were significantlyelevated between the patients with PROM 72hours and PROM<12hours (P<0.05). The values ofcord blood C3 (P<0.05), C4 (P<0.05) were significantly decreased in the patients with PROM.Conclusions:Not all cord blood immunoglobulins increased in the neonates of the history of PROM.The factor of PROM didn’t affect the cord blood levels of IgG, and while the values of IgA and IgMincreased, concentrations of complements decreased. IgA, IgM and C3, C4 can indicate that theindividual of neonates with PROM involved in intrauterine infections, and can serve as a valuableindex to indicate the intrauterine infections occurred.