脐血血浆谷胱甘肽S-转移酶α1-1水平作为新生儿肝细胞完整性的标志物。

Umbilical cord plasma glutathione S-transferase alpha 1-1 levels as a marker of neonatal hepatocellular integrity.

作者信息

Knapen M F, Wong W Y, Mulder T P, Peters W H, Merkus H M, Steegers E A

机构信息

Department of Obstetrics and Gynecology, University Hospital St. Radboud, Nijmegen, The Netherlands.

出版信息

Obstet Gynecol. 1998 Apr;91(4):490-4. doi: 10.1016/s0029-7844(98)00041-6.

DOI:10.1016/s0029-7844(98)00041-6

PMID:9540928

Abstract

OBJECTIVE

To investigate possible delivery-related impaired neonatal hepatocellular integrity by assessment of arterial and venous umbilical cord plasma levels of glutathione S-transferase Alpha 1-1.

METHODS

Glutathione S-transferase Alpha 1-1 levels were assessed in arterial and venous umbilical cord, and maternal venous plasma samples. The influence of maternal, delivery, and neonatal characteristics on arterial umbilical cord glutathione S-transferase Alpha 1-1 levels was studied, using linear regression analysis after log-transformation.

RESULTS

Median (range) arterial umbilical cord glutathione S-transferase Alpha 1-1 plasma levels were higher than venous umbilical cord levels (9.68 [0.64-1125] microg/L and 7.66 [0.78-987.5] microg/L, respectively, P < .005). Median (range) arterial and venous umbilical cord glutathione S-transferase Alpha 1-1 levels were higher than, and did not correlate with, maternal venous plasma levels (8.79 [1.79-183] microg/L and 6.47 [1.58-164.5] microg/L versus 1.47 [0.46-10.4] microg/L, P < .001). Neonates born vaginally demonstrated higher median (range) levels than those delivered by cesarean (13.41 [1.02-1125] microg/L and 5.73 [0.64-172.90] microg/L, respectively, P < .001). Neonates with unfavorable pH (arterial pH under 7.20) demonstrated higher median (range) levels than those with normal pH (arterial pH at least 7.20) (15.15 [0.77-1125] microg/L and 8.82 [0.64-120.90] microg/L, respectively, P < .001). Stepwise multiple linear regression analysis showed that birth weight had the largest influence on arterial umbilical cord glutathione S-transferase Alpha 1-1 levels, followed by arterial base deficit, and route of delivery.

CONCLUSION

Arterial umbilical cord glutathione S-transferase Alpha 1-1 plasma levels, being unrelated to maternal venous levels, might give a reliable impression of early neonatal hepatocellular integrity and may become an additional indicator of neonatal condition immediately after birth.

摘要

目的

通过评估脐动脉血和脐静脉血中谷胱甘肽S-转移酶α1-1的水平，研究与分娩相关的新生儿肝细胞完整性受损的可能性。

方法

对脐动脉血、脐静脉血和母静脉血样本中的谷胱甘肽S-转移酶α1-1水平进行评估。采用对数转换后的线性回归分析，研究母亲、分娩及新生儿特征对脐动脉血谷胱甘肽S-转移酶α1-1水平的影响。

结果

脐动脉血中谷胱甘肽S-转移酶α1-1的血浆水平中位数（范围）高于脐静脉血（分别为9.68[0.64 - 1125]μg/L和7.66[0.78 - 987.5]μg/L，P <.005）。脐动脉血和脐静脉血中谷胱甘肽S-转移酶α1-1水平的中位数（范围）高于母静脉血血浆水平，且与母静脉血血浆水平无相关性（分别为8.79[1.79 - 183]μg/L和6.47[1.58 - 164.5]μg/L，而母静脉血为1.47[0.46 - 10.4]μg/L，P <.001）。经阴道分娩的新生儿谷胱甘肽S-转移酶α1-1水平中位数（范围）高于剖宫产分娩的新生儿（分别为13.41[1.02 - 1125]μg/L和5.73[0.64 - 172.90]μg/L，P <.001）。pH值异常（动脉血pH值低于7.20）的新生儿谷胱甘肽S-转移酶α1-1水平中位数（范围）高于pH值正常（动脉血pH值至少为7.20）的新生儿（分别为15.15[0.77 - 1125]μg/L和8.82[0.64 - 120.90]μg/L，P <.001）。逐步多元线性回归分析显示，出生体重对脐动脉血谷胱甘肽S-转移酶α1-1水平影响最大，其次是动脉碱缺失和分娩方式。