早产SGA产后24h内血清Ghrelin、IGF-1、INS水平与胎龄及体格发育指标相关性分析

Analysis of the Relevance of the Serum Ghrelin,IGF-1,INS Level with Gestational Age and Growth Indicators 24h After Premature SGA

目的研究早产小于胎龄儿（SGA）产后24 h血清中Ghrelin、胰岛素样生长因子（IGF-1）、胰岛素（INS）水平与胎龄以及发育指标的相关性。方法收集我院产科2006-10~2013-10间的出生的早产SGA500例,按照出生体重将病例分为三组：1000~1500 g的为A组（121例）,1500~2000 g的为B组（245例）,2000~2500 g的为C组（134例）,所有的患者分别于开奶前抽取静脉血2~3 m L,离心去血清后分别测定Ghrelin、IGF-1、INS水平,研究与胎龄以及体格发育的相关性。结果早产SGA产后24 h内血清Ghrelin随着体重的增加而逐渐降低,并且经过统计学检验三组之间的差异具有统计学意义（P〈0.05）,IGF-1、INS水平随着体重的增加逐渐升高,并且两种因素在三组之间的差异均具有统计学意义（P〈0.05）;利用Pearson相关性分析显示,早产SGA产后24 h内血清Ghrelin水平与胎龄、出生体质量、身长、BMI呈负相关,而与出生头围相关性不明显;IGF-1水平与胎龄、出生体质量、身长、头围、BMI呈正相关;INS水平与胎龄、出生体质量、身长、头围、BMI呈正相关。结论早产SGA产后24 h内血清Ghrelin、IGF-1、INS水平与胎龄及体格发育指标之间具有明显的相关性,同时可以将Ghrelin、IGF-1、INS水平作为婴儿体格发育的有效的指标。

Objective To study the relevance of the serum Ghrelin,IGF- 1 and INS level with gestational age and growth indicators24 h after premature SGA. Methods Collecting 500 cases with SGA infants born from October,2006 to October,2013,and dividing them into three groups according to the birth weight,1000 ~ 1500 g for group A（ 121 cases）,1500 ~ 2000 g for group B（ 245 cases）,2000 ~2500 g for group C（ 134 cases）. All patients were extracted venous blood 2 ~ 3 m L respectively before having breast- feed,Ghrelin,IGF- 1 and INS level were determined after centrifugal to serum,and the correlation of gestational age and physical development was researched. Results Serum Ghrelin reduced gradually with the increase of body weight 24 h after premature SGA,and the difference among three groups was statistically tested,with statistical significance（ P〈0. 05）. IGF- 1,INS level increased with body weight,and the differences between the two factors in three groups were statistically significant（ P〈0. 05）; Pearson correlation analysis showed that within24 h after premature SGA group,serum levels of Ghrelin was negatively correlated with gestational age,birth body mass,body length and BMI,while there was no obvious correlation with birth head circumference; IGF- 1 level and gestational age,birth body mass,body length,head circumference and BMI were positively correlated with INS. Conclusion The premature SGA infants within 24 h after birth and serum levels of Ghrelin,IGF 1,INS gestational age and physical development index have obvious correlation,at the same time Ghrelin,IGF- 1 and INS level can be regarded as the effective indicators of infant physical development.