Rogers M S, Wang W, Mongelli M, Pang C P, Duley J A, Chang A M
Department of Obstetrics and Gynaecology, Chinese University of Hong Kong, Shatin.
Gynecol Obstet Invest. 1997;44(4):229-33. doi: 10.1159/000291534.
This prospective study examined purine metabolism in relation to free oxygen radical activity, as reflected by lipid peroxide levels in umbilical cord blood at birth.
Departments of Obstetrics and Gynaecology and of Chemical Pathology, the Chinese University of Hong Kong, Hong Kong, and Purine Research Laboratory, UMDS of Guy's and St. Thomas' Hospitals, London, UK.
Umbilical cord arterial and venous blood samples were collected from 132 singleton term deliveries for determination of hypoxanthine, xanthine, inosine, uric acid, organic hydroperoxides (OHP) and malondialdehyde. Oxygen saturation, PO2, pCO2, pH, and base excess (BE) were also measured.
There was a significant correlation between umbilical arterial and venous levels of hypoxanthine, xanthine, inosine, uric acid and all acid-base parameters (p < 0.001). Significant arteriovenous differences were observed for all parameters with the exception of inosine, uric acid and OHP. Umbilical arterial xanthine and potassium correlated significantly with OHP, but hypoxanthine, inosine and uric acid did not. In 13 babies classified as severely asphyxiated at birth (umbilical arterial pH <7.15, BE <-8), xanthine and OHP levels were significantly elevated when compared with non-asphyxiated babies. No significant differences were observed for hypoxanthine, inosine or uric acid.
The findings indicate that OHP, either in cord arterial or venous blood, is the best marker of free oxygen radical activity in the fetus, and that this correlates with other evidence of cellular hypoxia-reperfusion injury. We propose OHP is a better measure of perinatal outcome than either acid-base balance or hypoxanthine.
本前瞻性研究探讨了嘌呤代谢与自由基活性的关系，自由基活性通过出生时脐带血中脂质过氧化物水平反映。
香港中文大学妇产科及化学病理学系，以及英国伦敦盖伊和圣托马斯医院医学与牙科学院嘌呤研究实验室。
收集132例单胎足月分娩的脐动脉和脐静脉血样本，测定次黄嘌呤、黄嘌呤、肌苷、尿酸、有机氢过氧化物（OHP）和丙二醛。同时测量血氧饱和度、PO2、pCO2、pH和碱剩余（BE）。
脐动脉和脐静脉中的次黄嘌呤、黄嘌呤、肌苷、尿酸水平与所有酸碱参数之间存在显著相关性（p < 0.001）。除肌苷、尿酸和OHP外，所有参数均观察到显著的动静脉差异。脐动脉中的黄嘌呤和钾与OHP显著相关，但次黄嘌呤、肌苷和尿酸与OHP无显著相关性。在13例出生时被分类为重度窒息的婴儿（脐动脉pH < 7.15，BE < -8）中，与未窒息婴儿相比，黄嘌呤和OHP水平显著升高。次黄嘌呤、肌苷或尿酸未观察到显著差异。
研究结果表明，脐动脉血或脐静脉血中的OHP是胎儿自由基活性的最佳标志物，并且这与细胞缺氧-再灌注损伤的其他证据相关。我们认为，与酸碱平衡或次黄嘌呤相比，OHP是围产期结局的更好指标。
