新生儿脐血中脑源性神经生长因子含量与营养供给状态的相关性
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摘要
目的探讨新生儿脐血中脑源性神经生长因子(BDNF)含量与营养供给状态的相关性。方法选择2013年8月—2016年8月湖北医药学院附属东风医院分娩的160例低出生体重儿,所有患儿都给予静脉注射和胃肠道供养的混合方法进行干预,把宫外发育迟缓30例归为观察组,非宫外发育迟缓130例归为对照组;评定新生儿的营养供给状态,同时进行脐血血浆中BDNF含量的测定与一般资料的调查。结果出生时2组新生儿胎龄、性别、体重、身长、头围对比差异均无统计学意义(均P> 0. 05)。观察组新生儿的重症感染、肺透明膜病、颅内出血等并发症发生率为30. 0%,对照组为5. 4%,观察组明显高于对照组(P <0. 05)。观察组与对照组的脐血BDNF含量分别为(2. 56±1. 21) ng/m L和(3. 48±0. 99) ng/m L,观察组明显低于对照组(P <0. 05)。相关性分析显示低出生体重儿的宫外发育迟缓与脐血中BDNF含量、重症感染、肺透明膜病、出生体重有明显相关性(均P <0. 05);Logistic回归分析显示影响低出生体重儿发生宫外发育迟缓的主要危险因素为脐血中BDNF含量低、重症感染、肺透明膜病(均P <0. 05)。结论低出生体重儿中的营养供给状态多存在不足,有比较高的宫外发育迟缓发生率,脐血中BDNF含量与营养供给状态存在明显的相关性,也是影响宫外发育迟缓发生的危险因素。
Objective To investigate the relationship between the levels of umbilical cord blood brain-derived neurotrophic factor( BDNF) and the status of nutritional supply in neonate. Methods One hundred and sixty low birth weight infants were given intravenous injection and mixed intervention method for gastrointestinal tract,the 30 infants with Eu GR were classified as observation group,and 130 infants with non-EuGR were classified as control group; the status of nutritional supply were given assessment,the levels of umbilical cord blood BDNP and general information were given detection and general information survey. Results The birth gestational age,sex,body weight,body length and head circumference compared between the two groups were not significant difference( all P > 0. 05). The incidence of severe infection,hyaline membrane disease,intracranial hemorrhage and other complications in the observation group was 30. 0%,so that was 5. 4% in the control group,the observation group was significantly higher than that in the control group( P <0. 05). The levels of BDNF of the observation group and the control group were( 2. 56 ± 1. 21) ng/m L and( 3. 48 ±0. 99) ng/m L,the observation group was significantly lower than that of the control group( P < 0. 05). Correlation analysis showed that the Eu GR were significant correlated to the levels of BDNF,birth body weight,severe infection,hyaline membrane disease in the low birth weight infants( all P < 0. 05); Logistic regression analysis showed that the low level of BDNF,severe infection,hyaline membrane disease were the main risk factors for the Eu GR in the low birth weight infants( all P < 0. 05). Conclusion The nutritional supply in low birth weight infant is more insufficient and has a relatively high incidence of Eu GR,the levels of umbilical cord blood BDNF and nutrient supply conditions have obvious correlation,but also the the risk factors for affecting Eu GR occurrence.
Objective To investigate the relationship between the levels of umbilical cord blood brain-derived neurotrophic factor( BDNF) and the status of nutritional supply in neonate. Methods One hundred and sixty low birth weight infants were given intravenous injection and mixed intervention method for gastrointestinal tract,the 30 infants with Eu GR were classified as observation group,and 130 infants with non-EuGR were classified as control group; the status of nutritional supply were given assessment,the levels of umbilical cord blood BDNP and general information were given detection and general information survey. Results The birth gestational age,sex,body weight,body length and head circumference compared between the two groups were not significant difference( all P > 0. 05). The incidence of severe infection,hyaline membrane disease,intracranial hemorrhage and other complications in the observation group was 30. 0%,so that was 5. 4% in the control group,the observation group was significantly higher than that in the control group( P <0. 05). The levels of BDNF of the observation group and the control group were( 2. 56 ± 1. 21) ng/m L and( 3. 48 ±0. 99) ng/m L,the observation group was significantly lower than that of the control group( P < 0. 05). Correlation analysis showed that the Eu GR were significant correlated to the levels of BDNF,birth body weight,severe infection,hyaline membrane disease in the low birth weight infants( all P < 0. 05); Logistic regression analysis showed that the low level of BDNF,severe infection,hyaline membrane disease were the main risk factors for the Eu GR in the low birth weight infants( all P < 0. 05). Conclusion The nutritional supply in low birth weight infant is more insufficient and has a relatively high incidence of Eu GR,the levels of umbilical cord blood BDNF and nutrient supply conditions have obvious correlation,but also the the risk factors for affecting Eu GR occurrence.
引文
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[14] VELASCO I,SANTOS C,LIMN J,et al. Bioactive components in human milk along the first month of life:effects of iodine supplementation during pregnancy[J]. Ann Nutr Metab,2016,68(2):130-136.
[15] WANG Y,CHEN L,GAO Y,et al. Effects of prenatal exposure to cadmium on neurodevelopment of infants in Shandong,China[J].Environ Pollut,2016,211(2):67-73.
[16] SENGOKU T,MURRAY K M,WILSON M E. Neonatal hyperoxia induces alterations in neurotrophin gene expression[J]. Int J Dev Neurosci,2016,48:31-37.
[17] RUSS K,FLORES J,BRUDEK T,et al. Neonatal human retinal pigment epithelial cells secrete limited trophic factors in vitro and in vivo following striatal implantation in parkinsonian rats[J]. J Neural Transm(Vienna),2016,123(3):167-177.
[18]任丽华,穆秀英,陈红艳,等.神经行为与不同铅暴露水平新生儿脐血中脑源性神经生长因子含量的相关性研究[J].中华预防医学杂志,2016,50(6):514-518.
[19] LAVEZZI A M. A new theory to explain the underlying pathogenetic mechanism of sudden infant death syndrome[J]. Front Neurol,2015,19(6):220-228.
[20]乔力媛,孙鸿燕,董文斌,等.新生期母婴分离导致大鼠海马区Caveolin-1、GFAP、BDNF表达下调[J].临床儿科杂志,2013,13(8):752-756.
[21] FLCK A,WEBER S K,FERRARI N,et al. Determinants of brainderived neurotrophic factor(BDNF)in umbilical cord and maternal serum[J]. Psychoneuroendocrinology,2016,63:191-197.
[22] MESQUITA A R,BELSKY J,LI Z,et al. Institutionalization and indiscriminate social behavior:Differential-susceptibility versus diathesis-stress models for the 5-HTTLPR and BDNF genotypes[J]. Physiol Behav,2015,152(11):85-91.
[2]章晓婷,龚华,陈文,等.极低出生体重儿出院后营养与生长发育监测[J].中华临床营养杂志,2016,24(5):299-302.
[3] YU X,CHEN L,WANG C,et al. The role of cord blood BDNF in infant cognitive impairment induced by low-level prenatal manganese exposure:LW birth cohort,China[J]. Chemosphere,2016,11(163):446-451.
[4]杨立.早产儿宫外神经发育迟缓及不同的营养支持方案对其干预的临床影响分析[J].中国现代药物应用,2016,10(8):102-104.
[5] HODYL N A,CRAWFORD T M,MCKERRACHER L,et al. Antenatal steroid exposure in the late preterm period is associated with reduced cord blood neurotrophin-3[J]. Early Hum Dev,2016,101:57-62.
[6]张小华,李双双,周金君.极低出生体重儿住院期间生长速度及相关影响因素分析[J].中国儿童保健杂志,2016,24(4):419-422.
[7] BBRICHELLO T,SIMES L R,GENEROSO J S,et al. Depressionlike adult behaviors may be a long-term result of experimental pneumococcal meningitis in wistar rats infants[J]. Neurochem Res,2016,41(10):2771-2778.
[8] LAVEZZI A M,FERRERO S,RONCATI L,et al. Impaired orexin receptor expression in the K9lliker-Fuse nucleus in sudden infant death syndrome:possible involvement of this nucleus in arousal pathophysiology[J]. Neurol Res,2016,38(8):706-716.
[9]张小华,李玉峰,周金君.极低出生体重儿早期营养对体格、智能发育的影响[J].中国儿童保健杂志,2016,24(10):1095-1098.
[10] D’ANGIO C T,AMBALAVANAN N,CARLO W A,et al. Blood cytokine profiles associated with distinct patterns of bronchopulmonary dysplasia among extremely low birth weight infants[J]. J Pediatr,2016,174(2):45-51.
[11]杨晓华,黄越芳,陈静贤,等.宫外生长迟缓早产儿生后18月的生长模式及影响因素[J].中华围产医学杂志,2016,19(10):766-771.
[12] CORDEIRO C N,SAVVAY,VAIDYA D,et al. Mathematical modeling of the biomarker milieu to characterize preterm birth and predict adverse neonatal outcomes[J]. Am J Reprod Immunol,2016,75(5):594-601.F
[13]张琼,高喜容,庄严,等.不同喂养方式对极低出生体重儿临床预后的影响及其随访观察[J].中国医师杂志,2016,18(7):1050-1053.
[14] VELASCO I,SANTOS C,LIMN J,et al. Bioactive components in human milk along the first month of life:effects of iodine supplementation during pregnancy[J]. Ann Nutr Metab,2016,68(2):130-136.
[15] WANG Y,CHEN L,GAO Y,et al. Effects of prenatal exposure to cadmium on neurodevelopment of infants in Shandong,China[J].Environ Pollut,2016,211(2):67-73.
[16] SENGOKU T,MURRAY K M,WILSON M E. Neonatal hyperoxia induces alterations in neurotrophin gene expression[J]. Int J Dev Neurosci,2016,48:31-37.
[17] RUSS K,FLORES J,BRUDEK T,et al. Neonatal human retinal pigment epithelial cells secrete limited trophic factors in vitro and in vivo following striatal implantation in parkinsonian rats[J]. J Neural Transm(Vienna),2016,123(3):167-177.
[18]任丽华,穆秀英,陈红艳,等.神经行为与不同铅暴露水平新生儿脐血中脑源性神经生长因子含量的相关性研究[J].中华预防医学杂志,2016,50(6):514-518.
[19] LAVEZZI A M. A new theory to explain the underlying pathogenetic mechanism of sudden infant death syndrome[J]. Front Neurol,2015,19(6):220-228.
[20]乔力媛,孙鸿燕,董文斌,等.新生期母婴分离导致大鼠海马区Caveolin-1、GFAP、BDNF表达下调[J].临床儿科杂志,2013,13(8):752-756.
[21] FLCK A,WEBER S K,FERRARI N,et al. Determinants of brainderived neurotrophic factor(BDNF)in umbilical cord and maternal serum[J]. Psychoneuroendocrinology,2016,63:191-197.
[22] MESQUITA A R,BELSKY J,LI Z,et al. Institutionalization and indiscriminate social behavior:Differential-susceptibility versus diathesis-stress models for the 5-HTTLPR and BDNF genotypes[J]. Physiol Behav,2015,152(11):85-91.