脐带因素与胎儿的生长发育的关系

Relationship Between the Umbilical Cord Factors and Fetal Growth and Development

目的探讨脐带血临床指标评价胎儿生长发育情况的临床应用价值。方法选取该院出生的新生儿96例,根据胎龄以及出生体重百分位数的关系将所有新生儿分为小于胎龄儿(SGA)组、适于胎龄儿(AGA)组以及大于胎龄儿(LGA)组,测量新生儿的出生体重、身长、头围、胎盘重量以及体质指数(BMI),同时采用放射免疫法检测新生儿的脐血瘦素、胰岛素样生长因子Ⅰ(IGF-Ⅰ)以及生长激素(GH),并分析与胎儿生长发育的关系。结果 LGA组新生儿脐带血瘦素、IGF-Ⅰ以及GH水平分别为(1.58±0.08)ng/mL、(4.52±0.98)ng/mL、(35.78±12.49)ng/mL,明显高于AGA组和SGA组新生儿,随着新生儿体重的增加,新生儿的身长、头围、胎盘重量以及BMI也会随着增加.新生儿脐带血瘦素、IGF-Ⅰ以及GH水平与体重、身长、头围、胎盘重量以及BMI均呈正相关。结论瘦素、胰岛素样生长因子Ⅰ(IGF-Ⅰ)以及生长激素(GH)在胎儿生长发育过程中发挥着重要的调节作用,作为评价胎儿生长发育状况及营养状态具有重要的临床应用价值。

Objective To investigate the clinical application value of umbilical cord blood indexes for evaluating the fetal growth and development. Methods 96 cases of neonates born in our hospital were selected and divided into small for gestational age （SGA） group, appropriate for gestational age （AGA） group and large for gestational age （LGA） group. The birth weight, length, head circumference, placental weight, and body mass index （BMI） of the newborns were measured. Umbilical cord blood leptin, insulin-like growth factor Ⅰ（IGF-I） and growth hormone （GH） were detected by radioimmunoassay, and the relationship between which and fetal growth and development was analyzed. Results The umbilical cord blood leptin, IGF-I and GH levels of the newborns in LGA group was（1.58±0.08） ng/mL, 4.52±0.98 ng/mL, （35.78±12.49） ng/mL, which was significantly higher than that of the new-borns in AGA group and SGA group, respectively. Along with the increase of birth weight, neonatal length, head circumference, placental weight and BMI of the newborns would increase, too. Neonatal umbilical cord blood leptin, IGF-I and GH levels and body weight, length, head circumference, placental weight, and BMI were positively correlated. Conclusion Leptin, insulin-like growth factorⅠ（IGF-I） and growth hormone （GH） play an important role in the regulation of fetal growth and development process, which have important clinical value in the evaluation of fetal growth and development condition and nutritional status.