宫内发育迟缓儿脐血胰岛素样生长因子-1、胰岛素和生长激素水平测定及意义

Umbilical cord serum levels of insulin-like growth factor-1,insulin and growth hormone in neonates with intrauterine growth retardation

目的研究宫内发育迟缓(IUGR)的发生与脐血中胰岛素样生长因子-1(IGF-1)、胰岛素(INS)和生长激素(GH)的关系,以探讨内分泌环境对胎儿IUGR的影响。方法选择新生儿63例(男37例,女26例),根据出生体重分为IUGR组(n=33)和正常出生体重组(对照组,n=30)。测定并比较两组脐血中IGF-1、INS和GH的含量。结果①IUGR组脐血中IGF-1和INS的水平均明显低于对照组,GH的水平明显高于对照组(P<0.05)。②相关分析显示出生体重与脐血中IGF-1水平呈正相关(r=0.625,P<0.01),与GH水平呈负相关(r=-0.257,P<0.05);胎龄与脐血中IGF-1水平呈正相关(r=0.271,P<0.05)。③多元线性逐步回归分析显示脐血IGF-1和INS水平是影响出生体重的重要因素。结论内分泌环境调控胎儿的生长发育,脐血中的IGF-1和INS水平对胎儿体重有影响,IGF-1水平低下可能是导致IUGR的原因之一。

Objective To investigate the levels of insulin-like growth factor-1 （IGF-1） ,insulin （ INS） and growth hormone （ GH） in the cord blood of neonates with intrauterine growth retardation （ IUGR） ,and to assess the effects of the endocrine environment on IUGR. Methods Sixty-three newborn infants were selected,including 37 males and 26 females. According to birth weight,they were classified into IUGR group （ n = 33） and control group （ normal birth weight,n = 30） . The levels of IGF-1,INS and GH in the cord blood were measured. Results Umbilical cord serum levels of IGF-1 and INS in the IUGR group were significantly lower than those in the control group. In contrast,umbilical cord serum GH levels in the IUGR group were significantly higher than those in the control group. Birth weight was positively correlated with umbilical cord serum IGF-1 levels （ r = 0. 625,P 0. 01） and negatively correlated with GH levels （ r = - 0. 257, P 0. 05） . Gestational age was positively correlated with umbilical cord serum IGF-1 levels （ r = 0. 271,P 0. 05） . Multiple linear stepwise regression analysis showed that umbilical cord serum IGF-1 and INS levels were significant influential factors for birth weight. Conclusions The endocrine environment controls the growth and development of the fetus. The levels of IGF-1 and INS in the cord blood are associated with fetal weight. The low umbilical cord serum levels of IGF-1 may be one of the reasons for resulting in IUGR.