宫内生长迟缓儿血清GH、IGF-1、IGFBP-3和瘦素水平及临床意义

Serum levels of GH,IGF-1,IGFBP-3 and leptin in the intrauterine growth retarded newborns and their clinical significance.

【目的】探讨宫内生长迟缓(intrauterine growth retarded,I UGR)新生儿血清生长激素(growth hormone,GH)、胰岛素样生长因子-1(insulin-like growth factor-1,IGF-1)、胰岛素样生长因子结合蛋白-3(insulin-like growth factorbinding protein-3,IGFBP-3)、瘦素的浓度水平及临床意义。【方法】选择出生48-72 h的I UGR新生儿62例和足月适于胎龄儿(appropriate for gestional age,AGA)37例与早产AGA36例,其中I UGR分为重度I UGR组(29例),轻度I U-GR组(33例)和足月小于胎龄儿(small for gestional age,SGA)32例与早产SGA30例;分别于上午9时抽取静脉血,分离血清。采用放射免疫法测定GH、IGF-1、IGFBP-3和瘦素。【结果】①足月SGA和足月AGA组血清GH、IGF-1、IGFBP-3、瘦素浓度(μg/L)分别为6.58±1.42和24.32±3.59,11.89±3.01和37.12±6.4,82.3±19.66和256.55±33.62,2.75±0.66和7.58±1.26;早产SGA和早产AGA组血清GH、IGF-1、IGFBP-3、瘦素浓度(μg/L)分别为8.18±2.55和13.83±3.98,13.59±4.83和21.05±3.44,93.48±16.44和157.33±39.34,3.21±0.61和4.9±0.83,各组比较有显著差异(P<0.05或P<0.01)。②轻度和重度I UGR组血清GH、IGF-1、IGFBP-3、瘦素浓度(μg/L)分别为5.82±1.02和8.67±2.07,9.96±2.19和14.56±3.87,77.48±20.51和99.13±7.16,2.61±0.63和3.31±0.51,两组比较差异均有显著性(P<0.01)。【结论】新生儿血清GH、IGF-1、IGFBP-3、瘦素浓度水平与胎儿生长发育有密切关系,是调节胎儿宫内生长发育的重要因素。

[Objective] To explore the serum levels of growth hormone（GH） ,insulin-like growth factor-1 （IGF-1）, insulin-like growth factor binding protein-3 （IGFBP-3） and leptin in the intrauterine growth retarded （IUGR） newborns and their clinical significance. [Methods] One hundred and thirty five newborns were selected 48～72 hours a.fter birth to divide into full term appropriate for gestational age （AGA） infants （n=37）, pre-term AGA infants （n 36）, full-term small for gestational age （SGA） infants（n=32） and pre-term SGA infants（n=30）. Among them were 29 infants of the severe IUGR group and 33 infants of the mild IUGR group. Venous blood was drawn to seperate serum in every newborn at 9：00a. m. for determining GH, IGF-1, IGFBP-3 and leptin by radioimmunoassay. [ Results ] ① The serum concentr ations （vg/L） ofGH, IGH- 1 , IGFBP 3 andleptininthefull- term SGA and full term AGA groups were 6. 5 8 ± 1. 4 2and 24.32±3.59, 11.89±3.01 and 37.12±6.4, 82.3±19.66 and 256.55±33.62, 2.75±0.66 and 7.58±1.26 respectively; the serum concentrations （μg/L） of GH, IGF-1, IGFBP-3 and [eptin in the pre-term SGA and pre-term AGA groups were 8.18±2.55 and 13.83±53.98,13.59±4.83 and 21.05±3.44, 93.48±16.44 and 157.33±39.34,3.21±0.61 and 4.9±0.83 respectively. Comparison between the relevant groups showed significant difference （P〈0.05 or 〈0.01）. （2） The serum concentrations （μg/L） of GH, IGF1, IGFBP-3 and leptin in the mild and severe IUGR groups were 5.82± 1.02 and 8.67±2.07, 9.96±2.19 and 14.56±3.87,77.48±20.51 and 99.13±7.16, 2.61±0.63 and 3.31±0.51 respectively. Comparison between the two groups showed significant difference （P〈0.01）. [Conclusion] The serum levels of GH, IGF1, IGFBP-3 and leptin in newborns have a close bearing on the growth and development of fetuses and they are important factors in regulating the intrauterine growth and development of fetuses.