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目的:探讨不同分娩方式对新生儿脐血瘦素、皮质醇含量影响及脐血瘦素、皮质醇含量与新生儿行为神经测定相关性。方法:随机选取将该院妇产科2013年5月~2014年3月之间出生的新生儿120例,其中剖宫产组52例、产道正常分娩组68例,分别检测两组新生儿出生时脐静脉血样本中的瘦素、皮质醇含量,测定两组新生儿出生后第3天、第5天的新生儿神经行为(NBNA)评分,比较两组以上测定指标的差异及进行相关性分析。结果:剖宫产组的瘦素、皮质醇分别为(6.68±2.57)ng/ml、(194.27±61.37)nmol/L均显著低于产道正常分娩组(15.24±5.21)ng/ml、(330.42±153.64)nmol/L且差异均具有统计学意义(P<0.05);剖宫产组在第3天、第5天的NBNA评分、行为能力评分、被动肌张力评分、主动肌张力评分、行为能力评分上均显著低于产道正常分娩组且差异均具有统计学意义(P<0.05)。新生儿脐带血瘦素与生后第3天、第5天NBNA评分的相关性(r=0.636、r=0.551)呈显著的正相关性;新生儿脐带血皮质醇与生后第3天、第5天NBNA评分的相关性(r=0.542、r=0.439)呈显著的正相关性;出生后第3天、第5天新生儿瘦素和皮质醇具有的相关性分别为〔(r=0.326,P=0.041)、(r=0.026 0,P=0.047)〕,新生儿的瘦素和皮质醇水平有显著的正相关关系。结论:剖宫产分娩方式会影响新生儿脐带血瘦素及皮质醇的水平,同时瘦素与皮质醇水平变化与新生儿NBNA评分具有很好的相关性。
Objective: To investigate the effects of different modes of delivery on cord blood leptin and cortisol levels in neonates and the correlation between cord blood leptin and cortisol levels and neonatal behavioral neuroimaging. Methods: A total of 120 newborns were randomly selected in this hospital from May 2013 to March 2014, including 52 cases of cesarean section and 68 cases of normal delivery group. The birth of two newborns The levels of leptin and cortisol in the samples of umbilical cord blood were measured. The neonatal neurobehavioral (NBNA) score was measured at 3 days and 5 days after birth, and the differences between the two groups were compared and correlated analysis. Results The levels of leptin and cortisol were (6.68 ± 2.57) ng / ml and (194.27 ± 61.37) nmol / L, respectively, in the cesarean section group were significantly lower than those in the normal delivery group (15.24 ± 5.21 ng / ml, 330.42 ± 153.64) nmol / L and the differences were statistically significant (P <0.05); NBNA score, performance score, passive muscle tension score, active muscle tension score, behavior of cesarean section group on the 3rd and 5th day Ability to score were significantly lower than the normal delivery group and the birth of the difference was statistically significant (P <0.05). Neonatal umbilical cord blood leptin and postnatal day 3, 5 days NBNA score correlation (r = 0.636, r = 0.551) showed a significant positive correlation; neonatal umbilical cord cortisol and postnatal day 3, There was a significant positive correlation between the NBNA score (r = 0.542, r = 0.439) on day 5 and the correlation between leptin and cortisol on neonatal day 3 and day 5 [(r = 0.326, P = 0.041), (r = 0.026 0, P = 0.047). There was a significant positive correlation between neonatal leptin and cortisol levels. Conclusion: Cesarean delivery method will affect the umbilical cord blood leptin and cortisol levels, while leptin and cortisol levels and neonatal NBNA score has a good correlation.