目的 评估早产儿脐血微量元素及氧化/抗氧化因子水平与新生儿呼吸窘迫综合征（NRDS）发病的相关性，为NRDS的发病机制研究及防治策略提供新思路。方法 以2022年12月至2023年12月在新生儿科住院的胎龄<34周早产儿为研究对象。采用火焰原子吸收法测定微量元素水平，酶联免疫吸附法测定氧化因子丙二醛（MDA）及抗氧化因子超氧化物歧化酶（SOD）水平。比较NRDS组与对照组上述指标的差异，采用受试者工作曲线（ROC）判定各指标预测NRDS发病的价值。结果 NRDS组脐血铜水平、锌水平显著低于对照组（P均<0.05）。NRDS组SOD水平低于对照组，MDA水平高于对照组（P均<0.05）。NRDS组SOD/MDA比值显著低于对照组(P<0.001)。脐血锌、铜、SOD、MDA、SOD/MDA预测NRDS发病的AUC分别为0.728、0.917、0.627、0.780、0.824。结论 脐血微量元素铜、锌水平降低及氧化/抗氧化因子失衡可能参与早产儿呼吸窘迫综合征发病。

Objective To determine the trace elements and oxidative/antioxidant factors in cord blood of premature infants, and to clarify their value in predicting the onset and evaluation of neonatal respiratory distress syndrome (NRDS). Methods Premature infants with gestational age less than 34 weeks who were hospitalized in the neonatal department from Dec. 2022 to Dec. 2023 were selected as the subjects. The levels of trace elements were determined by flame atomic absorption spectroscopy, and the levels of oxidative factor malondialdehyde (MDA) and antioxidant factor superoxide dismutase (SOD) were measured by surface linked immunosorbent assay. The differences in the above indicators between the NRDS group and the control group were compared. The value of each indicator in predicting the onset of NRDS were determined by the receiver operative curve (ROC). Results The cord blood copper levels and zinc levels in the NRDS group were significantly lower than those in the control group. The SOD level in the NRDS group was lower than that in the control group, and the MDA level was higher than that in the control group. Meanwhile, the SOD/MDA ratio in the NRDS group was significantly lower than that in the control group. The area under the curve of zinc, copper, SOD, MDA, and SOD/MDA in cord blood predicting the onset of NRDS were 0.728, 0.917, 0.627, 0.780, and 0.824, respectively. Conclusions The decrease in levels of trace elements copper and zinc in cord blood and the imbalance of oxidative/antioxidant factors are involved in the pathogenesis of neonatal respiratory distress syndrome.