兔先天性青光眼网络膜血管改变

目的　研究青光眼对视网膜脉络膜血液循环的影响。方法　选24月龄、体重3.5～4kg的先天性青光眼大耳白兔5只(7只眼),选10只同龄大耳白兔作为对照组。另选10只2月龄、体重2kg大耳白兔前房内灌注生理盐水制成急性高眼压模型。对三组兔进行眼底照像、闪光视诱发电位(FVEP)检查,观察视网膜脉络膜血管形态和FVEP的变化。对人工急性高眼压组还进行了闪光视网膜电流图(FERG)检查。结果　先天性青光眼组与同龄对照组相比视网膜脉络膜末梢血管网明显减少;人工急性高眼压组眼压升高后首先使视网膜脉络膜末梢血管网灌流不足,随着眼压的继续升高脉络膜大血管变细,末梢血管网灌流不足加重,眼压极度升高时脉络膜大血管血流中断。同龄正常对照组的FVEP的主波P100潜伏期是(83±9)ms,先天性青光眼组则为(112±14)ms,差异有非常显著意义(P＜0.01);人工急性高眼压组高眼压前为(69±5)ms,眼压60～80mm　Hg时延长为(81±7)ms,眼压在100～130mmHg时FVEP波形低平,近似直线;眼压恢复正常后2hFVEP的P100潜伏期为(82±8)ms。人工急性高眼压前后FERG变化显著。结论　青光眼可以影响视网膜脉络膜血液循环;可使FVEP、FERG发生变化。     

神经生长因子药效学研究

目的考察神经生长因子对视神经损害的疗效。方法腹腔注射二硫化碳致视神经损害的大鼠模型,给药组球后注射或肌内注射神经生长因子,每天一次,每周6d,共计3周,空白对照组球后注射等量生理盐水,于治疗前后测定大鼠模式翻转（FREP）和闪光视觉诱发电位。结果球后注射高剂量组大鼠在治疗10d和20d时各波潜伏时比对照组有显著缩短,而球后注射低剂量组和肌内注射高剂量组大鼠于治疗10d时FVEP各波潜伏时也显著缩短,肌内注射低剂量组大鼠于治疗20d时FEP的P1和P2波潜伏时也显著或非常显著缩短。结论神经生长因子对大鼠视神经损害有明显的治疗作用。     

不同胎龄早产儿早期凝血指标的变化及其临床意义

目的:研究不同胎龄早产儿早期凝血指标的变化及其临床意义。方法:选取2012年1月至2017年7月期间我院出生的新生儿392例为研究对象。根据新生儿胎龄的不同分为早期早产儿组(胎龄27~31周)78例、中期早产儿组(胎龄32~33周)102例、晚期早产儿组(胎龄34~36周)116例以及足月新生儿组(胎龄37~42周)96例。四组新生儿出生后2h内抽取静脉血检测凝血指标,包括凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、纤维蛋白原(FIB),并应用Pearson相关性分析分析新生儿胎龄与上述各项凝血指标水平的相关性。结果:早期早产儿组、中期早产儿组、晚期早产儿组、足月新生儿组的出生体重以及胎龄呈逐渐上升趋势,不同组别新生儿的出生体重以及胎龄差异均有统计学意义(P0.05)。早期早产儿组、中期早产儿组、晚期早产儿组、足月新生儿组PT、APTT均呈逐渐下降趋势,FIB呈逐渐上升趋势,不同组别新生儿PT、APTT、FIB差异均有统计学意义(P0.05)。Pearson相关性分析显示,新生儿胎龄与PT、APTT呈负相关(r=-0.567、-0.691,P=0.000、0.000),而新生儿胎龄与FIB水平呈正相关(r=0.623,P=0.000)。结论:不同胎龄早产儿早期凝血功能存在异常变化,新生儿胎龄与PT、APTT均呈负相关关系,与FIB呈正相关关系,临床应予以重视,及时检测其凝血指标,必要时应予以干预治疗。     

胚胎期下颌髁突软骨中糖胺多糖、纤维粘连蛋白和层粘连蛋白的表达

目的　观察不同时期胎儿髁突软骨中糖胺多糖、纤维粘连蛋白和层粘连蛋白的表达。方法　应用组织化学和免疫组织化学SP法检测 32例 13周～ 33周 (A组 13～ 17周 ,B组 18～ 2 2周 ,C组 2 3～ 2 7周 ,D组 2 8～ 33周 )胎儿髁突软骨中糖胺多糖、纤维粘连蛋白和层粘连蛋白 ,并行体视学图象分析。结果　髁突软骨中AB PAS在各组的灰度及积分光密度均无显著性差异 (P >0 . 0 5 )。FN、LN阳性表达位于软骨细胞外基质 ,增殖层和成软骨细胞层呈强表达 ,尤其在两层交界处 ,而肥大软骨细胞层中明显减弱。体视学分析表明LN在A组表达最强 ,其灰度及积分光密度均值与B、D组间均有显著性差异 (P <0 . 0 5 )。〔灰度 :A组 175 . 0 18± 8. 30 1、B组 187 16 2± 13 6 44、D组 190 5 5 0± 6 46 0 ;积分光密度 :A组 2 739± 0 799,B组 2 0 11± 0 85 5 ,D组 1 5 33± 0 42 7,均存在显著性差异 (P <0 0 5 )。FN在B组表达最强 ,灰度与A、C、D三组间存在显著性差异 (P <0 0 5或P <0 0 1) ;积分光密度与A、D组间有显著性差异 (P <0 0 5 )。〔灰度 :B组 173 0 89± 8 40 7、A组 182 0 45± 10 138、C组 188 70 1± 8 0 94、D组 195 417± 4 82 7;积分光密度 :A组 1 314± 0 86 9、B组 4 332± 2 5 37、D组 2 12     

早产儿肠道微生态变化及其与胎龄、出生体质量的关系

目的探讨早产儿肠道微生态变化及其与胎龄、出生体质量的关系。方法选取2018年5月至2020年5月我院收治的80例早产儿作为早产组,同期收治的80例足月新生儿作为对照组。收集入组新生儿出生后3 d、3周的粪便,比较2组研究对象粪便标本中细菌丰富度和Shannon Wiener指数;根据早产组胎龄和出生体质量不同分组,分析胎龄、出生体质量与肠道微生态变化的关系。结果(1)出生3 d,早产组新生儿粪便标本的DGGE图谱条带数、Shannon Wiener指数均显著低于对照组(t=3.179、3.521,均P<0.05);(2)出生3 d,胎龄34⁺¹~36⁺⁶周组新生儿粪便标本的DGGE图谱条带数、Shannon Wiener指数显著高于28~30周组、30⁺¹~32周组和32⁺¹~34周组(q=9.653、6.476、4.848和8.796、8.008、6.277,均P<0.05);(3)出生3 d,体质量>2 000 g组新生儿粪便标本的的DGGE图谱条带数、Shannon Wiener指数显著高于≤1 500 g组(q=5.601和4.593,均P<0.05);(4)不同出生体质量、胎龄的早产儿,出生3周粪便标本的DGGE图谱条带数、Shannon Wiener指数相比差异无统计学意义(F=1.577和2.326,均P>0.05)。结论与足月新生儿相比,早产儿出生后细菌定植出现延迟且多样性差,胎龄越小、出生体质量越低的早产儿的肠道菌群的多样性更低、定植延迟的可能性更大,出生3周后其肠道微生态逐渐恢复正常。     

新生儿败血症96例临床分析

新生儿败血症是新生儿时期较严重的感染性疾病 ,为了解目前新生儿细菌感染及耐药情况 ,以指导临床合理选择用药 ,现将我科 1 999年 1月至2 0 0 1年 1 2月收治的、符合败血症诊断标准 [1 ]的、资料完整的 96例新生儿败血症的临床治疗情况分析如下。1　临床资料1 .1　一般资料　 96例患儿中男 73例 ,女 2 3例 ,发病时间 :0～ 7天 (早发性 ) 37例 (占 38.5% ) ,该组患儿中有 1 6例具有高危因素 (如胎膜早破、孕妇感染等 ) ,胎龄 <37周 8例 ,≥ 37周 2 9例 ;8～2 8天 (晚发性 ) 59例 ,(占 61 .5% ) ,胎龄 <37周1 1例 ,≥ 37周 48例。 96例中 ,来…     

血管内皮细胞生长因子及其受体在IgA肾病患者肾组织中表达的研究

目的　检测 2 4例不同病理改变的IgA肾病患者肾组织中血管内皮细胞生长因子 (Vascularendothelialgrowthfactor,VEGF)及其受体VEGF R2 (flk 1)和Ⅳ型胶原的表达 ,并将其表达水平与临床病理改变进行相关分析。方法　应用免疫组织化学SP法。结果　VEGF主要表达于肾小球脏层上皮细胞 ,flk 1主要表达于肾小球和间质血管内皮细胞。肾小球内VEGF和flk 1表达呈正相关 (P <0 0 5 ) ,两者在中度病变组肾小球内表达最多 ,重度病变组表达最少 (P <0 0 5 )。随病理改变程度加重 ,患者 2 4h尿蛋白定量、血压、血肌酐水平均明显增高 (P <0 0 5 )。肾小球内VEGF表达在轻、中度病变组与尿蛋白水平呈正相关 (P <0 0 5 ) ;在重度病变组则无相关性 ,与患者血压、血肌酐水平也无明显相关性 (P >0 0 5 )。肾小球内Ⅳ型胶原随病变加重表达增多 ,在重度病变组表达最多 (P <0 0 1) ;在轻、中度病变组肾小球内VEGF表达与Ⅳ型胶原的表达呈正相关 (P <0 0 5 )。各组肾小球内VEGF表达与肾小球微血管密度呈正相关 (P <0 0 1) ,重度病变组肾小球微血管密度减少 (P <0 0 5 )。结论　这些结果说明VEGF在IgA肾病的病理进展过程中发挥重要作用 ,可能涉及内皮细胞通透性增强、细胞外基质合成增多、血管生成障碍等多种机制     

视神经远端切断后再生视网膜节细胞Bcl-2的表达

目的　成年金黄地鼠视神经远端切断后再生视网膜节细胞 (RGCs)Bcl 2的表达与再生的关系。方法　远端切断视神经并对接一段自体坐骨神经 ,玻璃体内注射CTx及 /或植入小段坐骨神经分支 (SN)。动物随机分为AG +CTx组 ;AG +SN组 ;AG +SN +CTx组 ,各组动物分别存活 4W ,用粒蓝 (GB)逆行标记和Bcl 2免疫荧光组织化学双标法观察再生的RGCs和Bcl 2表达。结果　再生RGCs胞质内有Bcl 2蛋白表达 ,玻璃体内给予CTx或植入SN组表达Bcl 2的再生RGCs分别为 32 2± 4 71和 2 9 4± 3 75个 ,约占其再生总数的 82 5 0 %及 80 96 % ,两组相比无显著性差异 (P >0 0 5 ) ;CTx与SN联用组Bcl 2阳性再生的RGCs为 15 1 8± 35 6 9个 ,占再生总数的 91 2 2 % ,与前两组相比 ,均有显著性差异 (P <0 0 5 )。结论　视神经远端切断后约 80 %的再生RGCs有Bcl 2表达 ,提示Bcl 2表达可能与节细胞再生有密切关系。     

新生儿缺氧缺血性脑病58例临床分析

新生儿缺氧缺血性脑病 (HIE)是指在围产期缺血缺氧窒息而导致脑的缺氧缺血性损害 ,临床出现一系列脑病的表现 ,发病率及死亡率极高。HIE主要见于严重窒息的足月新生儿 ,也可见于早产儿 ,缺氧可发生在产前也可发生在产时 ,本文就我院儿科 1 994年 6月至 1 999年 6月 5年间收治的58例 HIE资料分析如下。1　临床资料1 .1　一般资料　 58例中男 36例 ,女 2 2例 ;胎龄小于 37周 1 0例 (占 1 7.2 % ) ,42周 43例 (占74.1 % ) ,大于 42周 5例 (占 8.6% ) ;出生时体重小于 2 50 0 g1 0例 (早产儿 8例 ,足月儿 2例 ) ,2 50 0～ 40 0 0 g 46例 (占…     

维生素C和E合用对中华鳖幼鳖非特异性免疫功能的影响

本研究旨在探讨维生素C和E合用对中华鳖幼鳖非特异性免疫功能的影响。实验设 5组 ,5组饵料中维生素C和E的添加量依次为 0和 0mg/kg(对照组 ) ;2 5 0和 5 0mg/kg(实验Ⅰ组 ) ;2 5 0 0和 2 5 0mg/kg(实验Ⅱ组 ) ;2 5 0和2 5 0mg/kg(实验Ⅲ组 ) ;2 5 0 0和 2 5 0mg/kg(实验Ⅳ组 )。喂食 4周 ,取其血液 ,测定中华鳖血细胞的吞噬率、血清溶菌活力、杀菌活力、补体C3和C4。结果表明 ,实验Ⅱ—Ⅳ组 ,血细胞吞噬率和血清杀菌活力明显高于对照组 ,实验Ⅳ组明显高于其他 4组 ,并且维生素C和E之间有明显的协同作用。血清溶菌活力和补体C3的含量 ,在实验Ⅰ—Ⅳ组明显高于对照组 ,实验Ⅳ组明显高于其他 4组。补体C4在实验Ⅰ—Ⅳ组明显高于对照组 ,但实验Ⅰ—Ⅳ组间没有明显差别 ,维生素C和E间也没有协同作用。     

Postnatal growth and skeletal maturation of experimental preterm macaques (Macaca nemestrina)

The growth and skeletal maturation of nine preterm female pigtailed macaques (Macaca nemestrina) obtained by C-section at less than or equal to 155 postconceptional days were followed through six months of age. At C-section they were of normal size and maturation for gestational age. Compared with 50 normal females born at term (mean = 173 +/- 6.4 postconceptional days), preterm infants were also of normal size at term, but delayed in skeletal maturation, requiring about one month to achieve the standard.     

婴幼儿喂养指数法评价6~23月龄婴幼儿喂养状况的临床价值

摘要 目的：探讨婴幼儿喂养指数法（ICFI）评价6~23月龄婴幼儿的喂养状况的临床价值。方法：于2015年6月至2016年2月,按照多阶段分层整群随机抽样的方法,抽取1418例6~23月龄婴幼儿作为调查对象。根据世界卫生组织（WHO）喂养建议建立喂养指数体系（包括母乳喂养、奶瓶喂养、膳食多样性、食物频率和喂养频率）,进行ICFI评分。结果：本次共调查1418例婴幼儿,男766例（54.02 %）,女652例（45.98 %）。6~8月龄组482例（33.99 %）,9~11月龄组457例（32.23 %）,12~23月龄组479例（33.78 %）。母乳喂养率为45.06 %,随月龄增加母乳喂养率降低（x²=234.486,P<0.05）。奶瓶喂养率为74.75 %,随月龄增加奶瓶喂养率升高（x²=75.671,P<0.05）。膳食多样性总满分率为67.42 %,满分率随月龄增加而增加（x²=154.146,P<0.05）。6~8、9~11月龄食物频率总满分率由高到低依次为谷类、蔬菜/水果、蛋/鱼/禽肉类、豆类及其制品、畜肉类;12~23月龄依次为奶类及其制品、蔬菜/水果、蛋/鱼/禽肉类、畜肉类、豆类及其制品。三个月龄组间食物频率评分随月龄增加而增加（F=1240.819,P<0.05）。喂养频率满分率为41.11 %（583/1418）,随月龄增加而降低（x²=149.05,P<0.05）。结论：ICFI可客观地反映婴幼儿的喂养状况,目前6~23月龄婴幼儿喂养状况不容乐观,喂养状况随着月龄减小而变差。     

胎盘组织学绒毛膜羊膜炎与未足月胎膜早破后早产儿脑损伤关系

目的:研究胎盘组织学绒毛膜羊膜炎与未足月胎膜早破后早产儿出现脑损伤的相关性。方法:选取我院妇产科2017年1月至2019年12月收治的因胎膜早破生产的未足月早产儿80例,根据是否存在绒毛膜羊膜炎分为观察组(绒毛膜羊膜炎)和对照组(无绒毛膜羊膜炎),每组40例,患儿于胎龄40 w时行颅脑核磁共振检查(Magnetic Resonance Examination,MRI),对比两组脑室周围白质软化(periventricular leukomalacia,PVL)阳性率,且采用新生儿20项行为神经评分量表(neonatal behavior neurological assessment,NBNA)评价两组患儿神经行为,然后在纠正胎龄3、6个月时对两组患儿进行智能发育指数(mental developmentalindex,MDI)及心理运动发育指数(psychomotor development index,PDI)测定并对比。结果:观察组PVL阳性率为27.5%,高于对照组的10.0%(P<0.05);观察组纠正胎龄40 w NBNA得分为(31.02±3.51)分,对照组为(35.21±4.02)分,差异具有统计学意义(P<0.05);胎龄3个月,MDI得分在观察组与对照组间差异无具有统计学意义(P>0.05),但其PDI得分低于对照组(P<0.05);胎龄6个月,观察组MDI及PDI得分均低于对照组(P<0.05)。结论:绒毛膜羊膜炎与未足月胎膜早破后早产儿的脑部损伤情况具有一定相关性,可以作为预测早产儿脑损伤程度的一项指标。     

Pharyngeal fluid clearance and aspiration preventive mechanisms in sleeping infants

We sought to characterize ventilatory and airway protective responses to pharyngeal stimulation in young infants during sleep. We studied the various responses with respect to frequency of occurrence, effect of increased stimulus intensity, and relation of stimulus fluid to laryngeal structures. Two groups of infants were studied: healthy full-term infants (n = 5) and preterm infants with a history of prolonged apnea (n = 9). We used a nasopharyngeal catheter to deliver small boluses of warm saline (0.02-0.35 ml) to the oropharynx. Responses repeatedly observed in both infant groups included swallows, obstructed respiratory efforts, brief apnea, prolonged apnea, and cough. In both infant groups, swallows and obstructed breaths occurred frequently and cough and prolonged apnea infrequently. The functional significance of some response patterns was clear, whereas that of others was obscure. Larger stimulus volumes yielded more frequent responses (P less than 0.01), and preterm infants responded much more frequently than full-term infants (P less than 0.01). Prolonged apnea was a composite of the other responses and was much more common in preterm than full-term infants (P less than 0.01). The stimulus technique was performed under direct visualization of the airway in two deceased infants. The findings suggested that the relation of the piriform fossae to the interarytenoid notch is important in determining response frequency. Implications for regulation of the removal of upper airway secretions during sleep are discussed.     

脑脊液检查在早产儿及足月儿细菌性脑膜炎的诊断价值

目的:评价脑脊液检查在早产儿及足月儿细菌性脑膜炎诊断中的价值。方法:选取2014年6月1日至2016年12月31日上海市儿童医院新生儿科收治的行腰椎穿刺检查的447例新生儿,回顾性分析新生儿的一般资料、脑脊液常规生化、培养等指标,根据胎龄将患儿分为早产儿167例与足月儿280例,再根据有无患发细菌性脑膜炎分为早产儿细菌性脑膜炎27例(早产儿观察组)、早产儿非细菌性脑膜炎140例(早产儿对照组)、足月儿细菌性脑膜炎38例(足月儿观察组)、足月儿非细菌性脑膜炎242例(足月儿对照组),采用受试者工作特征(ROC)曲线评估蛋白定量、白细胞计数、葡萄糖对早产儿及足月儿细菌性脑膜炎的诊断价值。结果:与同组对照组相比,足月儿观察组和早产儿观察组蛋白定量和白细胞计数均明显升高,而葡萄糖含量显著下降,且差异均具有统计学意义(P0.05);本研究65例细菌性脑膜炎患儿脑脊液培养分离出11株细菌(16.9%)。足月儿脑脊液白细胞计数、蛋白定量以及葡萄糖诊断细菌性脑膜炎的ROC曲线下面积分别为0.995、0.846、0.703。早产儿脑脊液白细胞计数、蛋白定量以及葡萄糖诊断细菌性脑膜炎ROC曲线下面积分别为0.970、0.711、0.705。结论:脑脊液白细胞计数、蛋白定量在足月儿和早产儿细菌性脑膜炎中具有较高的诊断价值。     

Irregularities and power law distributions in the breathing pattern in preterm and term infants

Unlike olderchildren, young infants are prone to develop unstable respiratorypatterns, suggesting important differences in their control ofbreathing. We examined the irregular breathing pattern in infants bymeasuring the time interval between breaths ("interbreathinterval"; IBI) assessed from abdominal movement during 2 h of sleepin 25 preterm infants at a postconceptional age of 40.5 ± 5.2 (SD) wk and in 14 term healthy infants at a postnatal age of 8.2 ± 4 wk. In 10 infants we performed longitudinal measurements on twooccasions. We developed a threshold algorithm for the detection of abreath so that an IBI included an apneic period and potentially someperiods of insufficient tidal breathing excursions (hypopneas). Theprobability density distribution (P) of IBIs follows a power law,P(IBI)~IBI,with the exponent  providing a statistical measurement of the relative risk of insufficient breathing. With maturation,  increased from 2.62 ± 0.4 at 41.2 ± 3.6 wk to 3.22 ± 0.4 at47.3 ± 6.4 wk postconceptional age, indicating a decrease in longhypopneas (for paired data P = 0.002). The statisticalproperties of IBI were well reproduced in a model of the respiratoryoscillator on the basis of two hypotheses:1) tonic neural inputs to the respiratory oscillator are noisy; and2) the noise explores a criticalregion where IBI diverges with decreasing tonic inputs. Accordingly,maturation of infant respiratory control can be explained by the tonicinputs moving away from this critical region. We conclude thatbreathing irregularities in infants can be characterized by , whichprovides a link between clinically accessible data and theneurophysiology of the respiratory oscillator.

     

Maturation of the pituitary-thyroid axis during the perinatal period.

To clarify the maturation process of the pituitary-thyroid axis during the perinatal period, thyrotropin (TSH) response to thyrotropin releasing hormone (TRH) and serum thyroid hormone levels were examined in 26 healthy infants of 30 to 40 weeks gestation. A TRH stimulation test was performed on 10 to 20 postnatal days. Basal concentrations of serum thyroxine (T4), free thyroxine (free T4) and triiodothyronine (T3) were positively correlated to gestational age and birth weight (p less than 0.001-0.01). Seven infants of 30 to 35 gestational weeks demonstrated an exaggerated TSH response to TRH (49.7 +/- 6.7 microU/ml versus 22.1 +/- 4.8 microU/ml, p less than 0.001), which was gradually reduced with gestational age and normalized after 37 weeks gestation. A similar decrease in TSH responsiveness to TRH was also observed longitudinally in all of 5 high responders repeatedly examined. There was a negative correlation between basal or peak TSH concentrations and postconceptional age in high responders (r = -0.59 p less than 0.05, r = -0.66 p less than 0.01), whereas in the normal responders TSH response, remained at a constant level during 31 to 43 postconceptional weeks. On the other hand, there was no correlation between basal or peak TSH levels and serum thyroid hormones. These results indicate that (1) maturation of the pituitary-thyroid axis is intrinsically controlled by gestational age rather than by serum thyroid hormone levels, (2) hypersecretion of TSH in preterm infants induces a progressive increase in serum thyroid hormones, and (3) although there is individual variation in the maturation process, the feedback regulation of the pituitary-thyroid axis matures by approximately the 37th gestational week.     

Plasma selenium in preterm and term infants during the first 12 months of life

The goal of the present study was to prospectively assess the plasma selenium (Se) concentrations of term and preterm infants during the first year of life in relation to gestational age and nutrition.

Blood specimens were collected from orally formula-fed preterm infants (gestational age < 32 weeks, birth weight < 1500 g): 1.) in hospital and 2.) corrected for gestational age parallel to healthy term breast and formula-fed infants at the ages of 1, 4 and 12 months. All infants were fed according to a standardized nutritional concept, solids and follow-up formula were introduced at the age of 4 months.

Plasma selenium in preterm infants in hospital was 11.7 (6.5–20.8) g/l and 11.6 (8.8–16.7) g/l at 4 weeks corrected for gestational age. At the age of 4 months plasma selenium was still significantly lower than in the other groups: Preterm infants: 17.1 (10.4–30.5) g/l; formula-fed term infants: 31.3 (24.3–47.5) g/l; breast-fed term infants: 45.6 (27.1–65.1) g/l). The levels of breast-fed infants were significantly higher than those of both formula-fed groups up until the introduction of solids.

Preterm infants had significantly low plasma selenium levels up until a postnatal age of at least 6 months. The levels were lower than those of term infants fed an identical unsupplemented infant formula during the first 4 months of life. These data support routine monitoring in hospital and selenium supplementation of preterm infants, preferably in hospital before discharge.     

脂联素在早产儿血清中的表达及其与体格指标、载脂蛋白和骨密度的关系

目的:探讨脂联素在早产儿血清中的表达水平及其与体格指标、载脂蛋白和骨密度的相关性。方法:选择2017年1月至2018年5月期间我院新生儿科住院的早产儿72例作为研究组,另外选择同期我院出生的足月新生儿58例作为对照组。对比两组新生儿的一般资料、脂联素、载脂蛋白和骨密度水平,分析早产儿血清脂联素水平与体格指标、载脂蛋白和骨密度的相关性,同时分析影响血清脂联素水平的危险因素。结果:两组受试新生儿的性别、胸围、低密度脂蛋白(LDL-C)及高密度脂蛋白(HDL-C)之间的差异无统计学意义(P0.05);研究组新生儿的胎龄、体质量指数(BMⅠ)、身长、头围、总胆固醇(TC)及三酰甘油(TG)明显低于对照组(P0.05);与对照组相比,研究组新生儿血清脂联素、载脂蛋白A-Ⅰ(Apo A-Ⅰ)及左胫骨中段超声波在骨骼中的传播速度(SOS)水平明显下降,而载脂蛋白B(Apo B)和Apo B/Apo A-Ⅰ水平均显著升高,且差异均具有统计学意义(P0.05);早产儿血清脂联素水平与胎龄、BMⅠ、头围、TC、TG、Apo A-Ⅰ及SOS呈正相关(P0.05),与Apo B和Apo B/Apo A-Ⅰ水平呈负相关(P0.05);Logistic回归结果显示,胎龄、BMⅠ、Apo B/Apo A-Ⅰ及SOS是早产儿血清脂联素水平的影响因素(P0.05)。结论:早产儿血清脂联素水平低于足月儿,血清脂联素水平与体格指标、载脂蛋白及骨密度密切相关,可能对新生儿的生长发育具有重要的调节作用。