剖宫产对初乳分泌型免疫球蛋白A的影响

　　【摘要】 目的 探讨剖宫产对母体初乳中分泌型免疫球蛋白A(sIgA)含量的影响。方法 选择自然分娩(NL组)、剖宫产(CS组)的初产妇各10例，记录分娩后首次产生初乳的时间，测定首次产生初乳和初乳产生后24、48 h初乳中sIgA含量。结果 产生首次初乳的时间CS组明显晚于NL组(P<0.05);初乳中sIgA值：首次初乳、初乳产生后24 h NL组均高于CS组(P均<0.05);初乳产生后48 h 2组含量差异不明显(P>0.05)。结论 剖宫产延迟初产妇的初乳产生，减少初乳中sIgA含量。

　　【关键词】 自然分娩 剖宫产 初乳 分泌型免疫球蛋白A

　　The effects of cesarean section on the concentration of sIgA in human colostrum

　　WANG Quanying1, XU Depeng2, XU Tao3

　　(1. Department of Obstetrics and Gynecology, the 97th Hospital of PLA, Xuzhou, Jiangsu 221004， China;

　　2. Department of Anesthesiology, the 97th Hospital of PLA; 3. Department of Clinical Laboratory, the 97th Hospital of PLA)

　　Abstract:Objective To study the effects of cesarean section on the sIgA in human colostrum.Methods 20 primipara women were divided into a normal labor group (NL group, n=10) and a cesarean section group (CS group, n=10). The start of first colostrum production was recorded; the concentrations of sIgA in the first colostrum and 24 h and 48 h later were compared.Results The start of first colostrum production was earlier in NL than in CS (P<0.05). The sIgA content of colostrums in the first colostrum and 24 h colostrum was higher in NL group than in CS group (P<0.05), but the difference disappeared in the 48 h colostrum (P>0.05).Conclusion Cesarean section could delay the production of human colostrum and reduce the colostral content of sIgA in primipara.

　　Key words: normal labor; cesarean section; colostrum; sIgA

　　选择性剖宫产儿对感染的抵抗力下降易感染[1]，目前剖宫产比率在分娩中应用越来越高，有的甚至高达82.14%[2]。分泌型免疫球蛋白A(sIgA)是初乳中主要的免疫蛋白，有保护新生儿消化道，防止呼吸道及泌尿道感染等作用。本研究采用放射免疫比浊法对不同分娩方式的产妇初乳中sIgA进行了测定，观察剖宫产对产妇初乳中sIgA的影响，现报道如下。

　　1 资料和方法

　　1.1 一般资料 选择本院产科无妊娠并发症的正常初产妇20例，年龄22～32岁，妊娠38～41周，无产时、产后大出血以及产后、术后感染等症状。新生儿发育正常，无新生儿疾病。将产妇分为自然分娩组(NL组)和剖宫产组(CS组)，每组10例。CS组剖宫产的术式采用新式改良法。

　　1.2 方法 记录分娩后产生第1次初乳(首次初乳)的时间。取产妇分娩前及分娩后产生首次初乳时的静脉血3 ml，离心分离血清，-200℃冰箱保存。取(手挤采集乳样)产妇分娩后的首次初乳和初乳产生后24、48 h

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