胰岛素样生长因子Ⅰ及胰岛素与胎儿宫内发育迟缓发病的关系

The Effect of Insulin like Growth Factor I and Insulin on Intrauterine Fetal Growth Retardation

目的探讨胰岛素样生长因子Ｉ（ＩＧＦⅠ）及胰岛素（Ｉｎｓ）与胎儿宫内发育迟缓（ＩＵＧＲ）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１７例ＩＵＧＲ患儿、孕妇（ＩＵＧＲ组）血清及羊水中Ｉｎｓ和ＩＧＦⅠ水平，同期住院的正常晚期妊娠妇女３８例（正常妊娠组）作为对照。结果（１）ＩＵＧＲ组孕妇血清ＩＧＦⅠ为１１７．２９μｇ／Ｌ，低于正常妊娠组的２０７．０７μｇ／Ｌ，两者比较，差异有极显著性（Ｐ＜０．００２）；ＩＵＧＲ组脐血清ＩＧＦⅠ为１６．７３μｇ／Ｌ，低于正常妊娠组的４４．８９μｇ／Ｌ，两者比较，差异有极显著性（Ｐ＜０．００１）。（２）ＩＵＧＲ组孕妇血清Ｉｎｓ为１２．１８ｍＩＵ／Ｌ，高于正常妊娠组的７．１３ｍＩＵ／Ｌ，两者比较，差异无显著性（Ｐ＞０．０５）。结论ＩＧＦⅠ及Ｉｎｓ可能参与ＩＵＧＲ的病理生理过程。

Objective To evaluate the role of insulin like growth factor Ⅰ (IGF Ⅰ) and insulin (Ins) in the occurrence of intrauterine fetal growth retardation (IUGR). Methods The study group included 17 women with IUGR, and 38 normal third trimester pregnant women were served as contorl. Maternal venous blood samples were collected from all cases before cesarean section. Umbilical venous blood and amniotic fluid were collected at the time of operation. The concentrations of Ins were measured by radioimmunoassay and concentrations of IGF Ⅰ were assayed by ELISA. Results The maternal serum IGF Ⅰ in IUGR group (117.29 μg/L) was significantly lower than that in the control group (207.07 μg/L) ( P <0.002). The umbilical serum IGF Ⅰin IUGR group (16.73 μg/L) was significantly lower than that in the control (44.89 μg/L) ( P <0.001). There was no significant difference of maternal serum Ins between IUGR group (12.18 mIU/L) and control group (7.13 mIU/L). Conclusions The change of IGF Ⅰ and Ins levels in maternal and umbilical serum may play an important role in the pathophysiological changes in IUGR.