宫内发育迟缓与胰岛素样生长因子及其结合蛋白关系的研究

Relationship between intrauterine growth retardation and in sulin-like growth factor-1 and insulin-like growth factor binding protein-3

为探讨宫内发育迟缓 (IUGR)的发生机制 ,检测了 86例新生儿脐血胰岛素样生长因子 - 1(IGF- 1)、胰岛素样生长因子结合蛋白 - 3(IGFBP- 3)水平 ,并分析上述指标变化与胎儿期生长的关系。将 86例新生儿分为两组 ,IUGR(即小于胎龄儿 )组 2 2例 ,适于胎龄儿 (AGA)组 6 4例 ,采用竞争性放射免疫分析法 (RIA)测定两组脐血IGF- 1水平 ,非竞争性免疫放射分析法 (IRMA )测定 IGFBP- 3水平。结果显示 ,与 AGA组相比 ,IUGR组脐血IGF- 1和 IGFBP- 3水平显著降低 (P<0 .0 0 1) ;IGF- 1水平随胎龄及出生体重增加而增加 (P<0 .0 1) ;IGFBP- 3水平与胎龄及出生体重呈正相关 (P<0 .0 1) ;IGF- 1与 IGFBP- 3呈正相关 (P<0 .0 1)。认为 IUGR与 IGF- 1及其结合蛋白密切相关 ,不论何种原因引起的 IU GR,其脐血 IGF- 1、IGFBP- 3水平均低 ,IGF- 1水平下降与 IGFBP- 3下降相伴随 ;脐血 IGF- 1、IGFBP- 3水平与胎龄及出生体重呈正相关 ,随着胎龄的增加和出生体重的增长 ,IGF- 1、IGFBP- 3水平不断升高。

To search for the pathogenesis about IUGR,the serum insulin-like growth factor-1(IGF-1)and insulin-like growth factor binding protein-3(IGFBP-3)levels in cord blood of intrauterine growth retardation(IUGR)newborns were examined and the relationship between their changing degree and prenatal growth were analyzed 80 newborns were divided into IUGR group(n=22)and appropriate gestational age(AGA)group The cord serum IGF-1 level was measured by specific radioimmunoassays(RIA),the serum IGFBP-3 level by immunoradioassays(IRMA) Results showed that the concentrations of IGF-1 and IGFBP-3 were significantly lower in IUGR newborns than AGA group(t=2 29,P<0 05;t′=3 72,P<0 001,respectively) IGF-1 and IGFBP-3 levels increased with gestational age(r=0 472,P<0 01;r=0 360,P<0 01,respectively)and birthweight(r=0 517,P<0 01;r=0 363,P<0 01,respectively) The level of IGF-1 correlated positively to the level of IGFBP-3(r=0 334,P<0 01) This suggests that the growth retardation of IUGR newborns is correlate with lower IGF-1 and IGFBP-3 levels IGF-1 and IGFBP-3 levels increase with gestational age and birthweight