李文平,武红利,曹迪,张新颖,梁淑新,李瑞
LI Wenping,WU Hongli,CAO Di,ZHANG Xinying,LIANG Shuxin,LI Rui

• 1:河北大学临床医学院
• 2:河北大学附属医院产科

摘要(Abstract)：

目的:探讨孕期母体补充益生菌及分娩方式对新生儿胆红素代谢的影响。方法:将符合入组标准的200例孕妇均分为观察组(妊娠32～36周每日口服益生菌制剂1袋)及对照组(不予干预),再依据分娩方式分为剖宫产组与经阴道分娩组,收集各组孕妇一般资料[孕妇年龄、孕期增重、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、血红蛋白(HGB)含量及肌酐水平]及新生儿一般资料[新生儿性别比例、出生孕周、体质量、身长、阿氏(Apgar)评分]、新生儿脐静脉血总胆红素(TB)、结合胆红素(CB)、未结合胆红素(UCB),比较新生儿出生后24、48及72 h的经皮胆红素(TCB)值。结果:各组孕妇及新生儿一般情况比较,差异无统计学意义(P> 0.05);观察组中剖宫产及经阴道分娩新生儿脐带血TB、UCB均低于对照组相同分娩方式新生儿,差异有统计学意义(P <0.05);观察组中剖宫产及经阴道分娩新生儿出生后24、48及72 h的TCB均低于对照组相同分娩方式新生儿,48 h与72 h的TCB比较,差异有统计学意义(P <0.05); 2组新生儿中,经阴道分娩新生儿脐带血TB、UCB及CB均低于剖宫产新生儿,但差异无统计学意义(P> 0.05);观察组经阴道分娩新生儿出生后24、48及72 h的TCB均低于本组剖宫产新生儿,48 h与72 h的TCB比较,差异有统计学意义(P <0.05);对照组经阴道分娩新生儿48及72 h的TCB低于本组剖宫产新生儿,差异有统计学意义(P <0.05)。结论:孕母妊娠32～36周补充益生菌制剂,可促进新生儿胆红素的代谢,降低新生儿胆红素水平;且经阴道分娩方式可以促进新生儿胆红素代谢。
Objective: To investigate the effects of maternal probiotics supplementation during pregnancy and delivery mode on bilirubin metabolism in neonates. Methods: 200 pregnant women who met the inclusion criteria were divided into an observation group( daily oral administration of a bag of probiotics for 32 to 36 weeks' gestation) and a control group( without intervention). After giving birth,they were divided into a cesarean section group and a vaginal delivery group according to the delivery mode. General information of pregnant women in each group such as age, weight gain during pregnancy,alanine aminotransferase( ALT),aspartate aminotransferase( AST),hemoglobin( HGB)and creatinine as well as general information of newborns such as sex ratio at birth,gestational age,body mass,body length,and Apgar score were collected. The total bilirubin( TB),bound bilirubin( CB) and unbound bilirubin( UCB) in umbilical venous blood of neonates were also collected. The values of transdermal bilirubin( TCB) at 24,48 and 72 h after birth were compared. Results: The comparison of general conditions of pregnant women and newborns in each group showed no statistically significant difference( P > 0. 05); In the observation group,TB and UCB of umbilical cord blood of newborns delivered by cesarean section and vaginal delivery were lower than those in the control group,and the differences were statistically significant( P < 0. 05). TCB at 24,48 and 72 h after birth of cesarean section and transvaginal delivery newborns in the observation group was lower than that of the control group,and TCB at 48 and 72 h after birth showed statistically significant difference( P <0. 05); In the two groups of newborns,TB,UCB and CB of umbilical cord blood of newborns delivered through vagina were all lower than those delivered by cesarean section,but the differences were not statistically significant( P > 0. 05). TCB of newborns delivered through vagina at 24,48 and72 h after birth in the observation group was lower than that of newborns delivered through cesarean section,and TCB at 48 and 72 h of life was statistically significant( P < 0. 05). In the control group,the TCB of newborns delivered by vagina for 48 and 72 h of life was lower than that of the newborns delivered by cesarean section,and there was a statistically significant difference( P < 0. 05).Conclusion: Probiotics supplementation at 32 to 36 weeks ' gestation can promote the metabolism of bilirubin in neonates and reduce the bilirubin level. Transvaginal delivery can boost the metabolism of bilirubin in neonates.

关键词(KeyWords)： 怀孕期间;婴儿,新生;胆红素;黄疸;肝功能;益生菌
peripartum period;infant,newborn;bilirubin;jaundice;liver fuction;probiotics

Abstract:

Keywords:

基金项目(Foundation): 河北省自然科学基金项目(H2018201179)

作者(Author): 李文平,武红利,曹迪,张新颖,梁淑新,李瑞
LI Wenping,WU Hongli,CAO Di,ZHANG Xinying,LIANG Shuxin,LI Rui

DOI: 10.19367/j.cnki.2096-8388.2020.08.019

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