胰岛素样生长因子-I与早产儿早期营养及生长关系的临床研究

Clinical relationship between insulin-like growth factor-I and early nutrition as well as growth of premature infants

目的探讨血胰岛素样生长因子I(IGFI)与早产儿早期营养、生长调控的关系。方法采用酶联免疫法测定41例早产适于胎龄儿出生后第8、15天的血清IGFI质量浓度。同时监测早产儿的体重、Kaup指数以及每天实际摄入的能量、蛋白质和母乳量。结果早产儿出生后第8天血清IGFI质量浓度与胎龄、出生体重以及出生后3～7d实际摄入的能量、蛋白质的量呈正相关(P<0.05)。第15天血清IGFI质量浓度与出生后8～14d实际摄入的能量、蛋白质的量呈正相关(P<0.05),而与胎龄、出生体重不相关(P>0.05)。早产儿在出生体重、胎龄、摄入的蛋白质和能量的量同等的情况下,摄入母乳量对血清IGFI质量浓度有正性影响(P<0.05)。血清IGFI质量浓度随着早产儿的日龄而上升,与体重增长速度和Kaup指数呈正相关(P<0.05)。结论血清IGFI质量浓度受到早产儿摄入能量、蛋白质、母乳量和日龄的影响,是早产儿生后早期的生长调控激素,IGFI可作为反映早产儿早期营养和生长的一个指标。

Objective To investigate the clinical relationship between insulin-like growth factor-Ⅰ （ IGF-Ⅰ） and early nutrition as well as growth of premature infants： Methods IGF-Ⅰ was analyzed by means of enzyme-linked immunosorbent assay in 41 premature appropriate for gestational infants on the 8^th and 15^th day. At the same time, the premature infants body weight and Kaup index were examined. Daily intake of the quantity of energy,protein and the volume of human milk were also recorded. Results The levels of serum IGF-Ⅰ at day 8 correlated positively with gestational age,birth weight, the mean energy and protein intake between day 3 and day 7 （ P 〈 0. 05 ）. The levels of serum IGF-Ⅰ at day 15 correlated positively with weight growth velocity,the mean energy and protein intake between day 8 and day 14（ P 〈 0. 05 ）, but not correlated with gestational age and birth weight （ P 〉 0. 05 ）. The intake of the human milk had a positive influence on the levels of serum IGF-Ⅰ when the gestational age, birth weight, the mean energy and protein intake were at the same levels （ P 〈 0. 05 ）. The more postnatal days of age of premature infants, the higher levels of serum IGF-Ⅰ. The levels of serum IGF-Ⅰ correlated positively with weight growth velocity and the Kaup index （ P 〈 0. 05 ）. Conclusion The levels of serum IGF-Ⅰ are influenced by the quantity of energy, protein, the volume of human milk intake and age. IGF-Ⅰ participates in the modulation of early postnatal growth in premature infants and may be an index of nutrition and growth.