胰岛素样生长因子-1及内皮素-1水平与胎儿宫内发育受限发病的关系

The relationship between the levels of the insulin like growth factor-1, endothelin-1 and the pathogenesis of fetal growth restriction

目的探讨胰岛素样生长因子-1(IGF-1)及内皮素-1(ET-1)与胎儿宫内发育受限(FGR)发病的关系。方法应用放射免疫分析法和酶联免疫吸附试验,分别测定21例FGR患儿脐血、孕妇(FGR组)血清及羊水中IGF-1和ET-1水平,同期住院的正常晚期妊娠妇女34例(正常妊娠组)作为对照。结果(1)FGR组孕妇血清IGF-1为112.16±7.02μg/L,低于正常妊娠组的207.07±8.25μg/L,两者比较,差异有显著性(P<0.01);FGR组脐血清IGF-1为16.27±7.38μg/L,低于正常妊娠组的44.89±6.44μg/L,两者比较,差异有极显著性(P<0.001);FGR组羊水中IGF-1与正常妊娠组无明显差异(P>0.05);(2)FGR组脐血清ET-1为79.34±3.67μg/L,高于正常妊娠组的43.96±4.16μg/L,两者比较,差异有显著性(P<0.01);FGR组羊水中ET-1水平(21.96±1.89μg/L)明显高于正常妊娠组(10.41±2.13μg/L),两组相比有显著差异(P<0.01);而FGR组孕妇血清ET-1与正常妊娠组相比无明显差异(P>0.05)。结论IGF-1及ET-1在FGR的发病中可能起到重要作用有关。

Objective ： To explore the relationship between the levels of insulin like growth factor - 1 （ IGF - 1 ）, endothelin - 1 （ ET - 1 ） and the pathogenesis of fetal growth restriction. Methods： The study group include 21 women with FGR, and 34 normal trimester pregnant women were served as control. Radioimmunoassay and ELISA were respectively used to detect the levels of IGF - 1 and ET - 1 in sample from umbilical venous blood, maternal venous blood and amniotic fluid of all cases. Results ： The maternal serum IGF - 1 in FGR group （ 112. 16 ±7.02μg/L） was significantly lower than that in the control group （207.07 ±8. 25μg/L） （ P 〈0. 01 ）. The umbilical serum IGF - 1 in FGR group （ 16.27 ±7. 381μg/L） was significantly lower than that in the control （44, 89 ±6. 44μg/L） （ P 〈0. 001 ）. There was no significant difference of amniotic fluid IGF - 1 between FGR group and control group （ P 〉0. 05）. The umbilical serum ET - 1 in FGR group （79. 34 ± 3. 67μg/L） was significantly higher than that in the control （43.96 ±4. 16μg/L） （ P 〈0. 01 ）. The amniotic fluid ET - 1 in FGR group （21.96 ± 1. 891μg/L） was significantly higher than that in the control （ 10. 41 ±2. 13μg/L） （ P 〈0.01 ）, There was no significant difference of maternal serum ET - 1 between FGR group and control group （ P 〉 0. 05）. Conclusions ： The change of IGF - 1 and ET - 1 levels may play an important role in the pathogenesis of FGR.