生长激素和胰岛素与新生儿宫内生长发育的关系

Relationship of Serum Growth Hormone and Insulin at Birth with Neonatal Intrauterine Growth

目的探讨生长激素(GH)和胰岛素(INS)与新生儿宫内生长发育的关系。方法研究对象为2010年1月-2011年1月在北京大学第三医院住院的73例健康足月新生儿和97例早产儿,研究对象均在出生24 h内取静脉血,采用酶联免疫吸附法检测血清GH和INS水平,同时核对胎龄及测量新生儿的出生体质量、头围和身长,比较新生儿出生24 h内血清GH和INS水平与胎龄、出生体质量、身长、头围的关系。结果 1.新生儿的胎龄与出生时血清GH水平呈负相关(r=-0.403,P=0.000),而与血清INS水平呈正相关(r=0.247,P=0.001);早产组出生时血清GH水平[(40.54±19.58)μg·L-1]显著高于足月组[(26.23±18.30)μg·L-1],而血清INS水平[(2.58±2.78)IU·L-1]则显著低于足月组[(4.02±3.60)IU·L-1](P=0.000,0.029)。2.足月儿的出生体质量、身长、头围与出生时血清GH水平均呈负相关,而与血清INS水平均呈正相关;早产儿仅出生体质量与血清GH水平呈负相关,与血清INS水平呈正相关。3.足月新生儿出生时血清GH与INS水平无相关性(r=0.291,P=0.090),而早产儿出生时血清GH与INS水平呈负相关(r=-0.353,P=0.004)。结论新生儿出生时GH和INS水平与其宫内发育密切相关,GH和INS可能参与调节新生儿宫内的生长发育。

Objective To study the relationship among the levels of serum growth hormone （ GH）, insulin （INS） at birth and the intrau- terine growth of neonates. Methods During Jan. 2010 to Jan. 2011,73 healthy full - term and 97 premature neonates, hospitalized in Peking University Third Hospital were studied. Blood samples were collected, and gestational age, birth weight, head circumference and length of neo- nates were checked within 24 hours after birth. The levels of serum GH and INS were measured by enzyme - linked immunosorbent assay. The correlation was analyzed between serum GH, INS and gestational age, birth weight, length, head circumference of neonates. Results l. Gesta- tional age was negatively correlated with serum GH（ r = -0.403, P = 0. 000 ）, but was positively correlated with serum INS （r = 0. 247, P = 0. 001 ）. The premature neonates had a significantly higher serum GH[ （40.54±19.58 ） μg · L^-1 ] than the full - term neonates [ （26.23±18.30） μg · L^-1] ,while the serum INS [ （2.58±2.78 ） IU·L^-1] decreased significantly than the full -term neonates [ （4.02±3.60 ） IU·L^-1] （P = 0. 000,0. 029）. 2. By controlling gestational age ,the partial correlation analysis showed that the birth weight, length and head circumference of the full -term were all negatively correlated with serum GH, but all positively correlated with serum INS. For premature neo- nates, only birth weight was negatively correlated with serum GH, but positively correlated with serum INS. 3. Serum INS was not correlated with serum GH in full - term neonates （ r = 0. 291, P = 0. 090 ）, but was negatively correlated in preterm neonates （ r = - 0. 353, P = 0. 004）. Conclusions The levels of GH and INS at birth are closely related to the maturity of the fetus, while GH and INS may be involved in regulating intrauterine growth and development.