陈晓玲 黄向贵 周泳宜 罗立荣 黄为民

【摘要】目的 探讨宫内高血糖暴露对新生儿脐带血炎症细胞因子水平及婴儿过敏性疾病发生的影响。方法 选择112例产妇及其新生儿，根据孕期血糖情况分为宫内高血糖暴露组（55例）和无宫内高血糖暴露组（57例），比较2组新生儿出生时脐带血中的炎症细胞因子水平差异。随访1年，比较2组婴儿过敏性疾病如特应性皮炎、婴幼儿喘息等的发生率，分析宫内高血糖对新生儿免疫力及婴儿过敏性疾病的影响。结果 2组新生儿脐带血IL-1β、IL-2、IL-6、IL-8、IL-10、IL-12、TNF-α质量浓度比较差异均无统计学意义（P均> 0.05）。宫内高血糖暴露组新生儿脐带血IL-4质量浓度为（30.180±8.648）pg/mL，高于无宫内高血糖暴露组的（22.500±10.100）pg/mL（P < 0.05）；随访1年，婴儿过敏性疾病发生率（34.7%）有高于无宫内高血糖暴露组（24.0%）的趋势，但组间比较差异无统计学意义（P > 0.05）。结论 宫内高血糖暴露对新生儿脐带血细胞因子IL-4质量浓度有一定影响，这或许能为今后过敏性疾病早期干预提供依据。

【关键词】新生儿；脐带血；细胞因子；宫内高血糖；过敏

Effect of intrauterine hyperglycemia on levels of neonatal inflammatory cytokines and the occurrence of allergic diseases in infants

CHEN Xiaoling1，2， HUANG Xianggui2， ZHOU Yongyi3， LUO Lirong2， HUANG Weimin1

（1. Department of Neonatology， the First Clinical Medical College of Southern Medical University （Southern Hospital），

Guangzhou 510515， China； 2. Department of Pediatrics， Guangzhou Red Cross Hospital， Guangzhou 510220， China；

3. Department of Obstetrics， Guangzhou Red Cross Hospital， Guangzhou 510220， China）

Corresponding author： HUANG Weimin， E-mail： hwmnet@21cn.com

【Abstract】Objective To evaluate the effect of intrauterine hyperglycemia exposure on inflammatory cytokine levels in neonatal umbilical cord blood and the incidence of allergic diseases in infants. Methods 112 pregnant women and their infants were enrolled. According to the glucose levels during pregnancy， all women were divided into the intrauterine hyperglycemia exposure （n = 55） and non-intrauterine hyperglycemia exposure groups （n = 57）. The levels of inflammatory cytokines in the umbilical cord blood were compared between two groups. During 1-year follow-up， the incidence of allergic diseases such as atopic dermatitis and wheezing in infants was compared between two groups. The impact of intrauterine hyperglycemia on neonatal immunity and infant allergic diseases was evaluated. Results There were no significant differences in the levels of IL-1β， IL-2， IL-6， IL-8， IL-10， IL-12 and TNF-α between two groups （all P > 0.05）. In the intrauterine hyperglycemia exposure group， the IL-4 level in the umbilical cord blood was （30.180±8.648） pg/mL， significantly higher than （22.500±10.100） in the non-intrauterine hyperglycemia exposure group （P < 0.05）. In the intrauterine hyperglycemia exposure group， the incidence of allergic diseases was 34.7%， higher compared with 24.0% in the non-intrauterine hyperglycemia exposure group during 1-year follow-up. However， there was no significant difference between two groups （P > 0.05）. Conclusion Intrauterine hyperglycemia exposure exerts certain effect on the IL-4 level in the neonatal cord blood， which may provide evidence for early intervention of allergic diseases.

【Key words】Newborn； Umbilical cord blood； Cytokine； Intrauterine hyperglycemia；Allergy

随着糖尿病全球患病率的持续上升，妊娠期高血糖（hyperglycemia in pregnancy，HIP）的发病

率也在上升，HIP包括孕前糖尿病合并妊娠（pre-gestational diabetes mellitus，PGDM）、糖尿病前期合并妊娠血糖控制不佳者、妊娠期糖尿病（gestational

diabetes mellitus，GDM），HIP母亲的后代受到越来越多的关注［1］。宫内高血糖环境是指孕妇在妊娠期间血糖水平升高，导致胎儿在子宫内暴露于高血糖环境中。这种情况通常与孕妇患有GDM或糖代谢紊乱有关。目前，宫内高血糖环境是一个重要的研究领域，研究者正在深入了解其对HIP孕妇后代健康的影响，并寻找预防和治疗的方法，以促进相关新生儿的生长发育。研究表明，HIP可能与后代心血管疾病、哮喘、高度近视、注意缺陷多动障碍等相关［2］。有研……