脂联素、胰岛素生长因子-Ⅰ、前清蛋白与早产儿宫外发育缓慢的相关性

Correlation of the Serum Levels of Adiponectin, IGF-Ⅰ, PA with EUGR in Preterm Infants

目的:探究早产儿血清脂联素、胰岛素生长因子-Ⅰ(IGF-Ⅰ)、前清蛋白(PA)水平,并分析其与早产儿宫外发育缓慢(EUGR)的相关性。方法:选择2014年1月~2016年1月于我院产科出生并在24 h内转入新生儿科的321例早产儿,将321例早产儿分为EUGR组和非EUGR组。比较两组新生儿生长发育情况及血清脂联素、IGF-Ⅰ、PA水平。结果:321例早产儿中EUGR发生率为55.76%(179/321);EUGR组新生儿在出生后第42 d及三个月时体重与非EUGR组比较明显较低,且差异具有统计学意义(P<0.05)。两组早产新生儿出生后第42 d及三个月时体重与我国9市儿童体格发育数值表相比,体重标准差(SDS)均为负值,且EUGR组新生儿的体重标准差(SDS)显著低于非EUGR组(p<0.05)。出生后第7天,EUGR组与非EUGR组新生儿血清脂联素、IGF-Ⅰ、PA水平均显著低于对照组,且EUGR组的PA水平显著低于非EUGR组(p<0.05)。出生后第14天,EUGR组血清脂联素、PA水平与第7天相比差异无统计学意义(p>0.05),非EUGR组的血清脂联素、PA水平明显增加,显著高于EUGR组(p<0.05),EUGR组和非EUGR组新生儿血清IGF-Ⅰ水平均无明显改善(p>0.05)。结论:较低水平的血清脂联素、IGF-Ⅰ、PA与早产儿宫外发育缓慢密切相关,可作为临床上早期判断宫外发育迟缓的辅助参考指标。

Objective： To explore the levels of serum adiponectin, insulin growth factor Ⅰ （IGF- Ⅰ） and prealbumin in preterm infants, and analyze their correlation with preterm EUGR infant. Methods： 321 cases of preterm infants who were born in our hospital and transferred to neonatal department in 24 hours from January, 2014 to January, 2016 were enrolled in the present study. According to the weight at discharge, they were divided into the EUGR group and the non EUGR group, the growth and development as well as the levels of serum adiponeetin, IGF- Ⅰ and PA in the two groups were compared. Results： The occurrence rate of EUGR was 55.76% （179/321） in the 321 cases of preterm infants; the weight of EUGR group was significantly lower than that of the non EUGR group at 42 th days and three months after birth（p〈0.05）. The SDS of both groups were all negative, and that of EUGR group was significantly lower than non EUQR group （p〈0.05）. The levels of serum adiponectin, IGF- Ⅰ and PA of both groups were significantly lower than the control group at seventh days of birth, and the PA level of EUGR group was significantly lower than non EUGR group （p〈0.05）. There was no significant difference in the serum adiponectin and PA levels between 7 days and 14 days in EUGR group （P 〉 0.05）, however, the serum adiponectin and PA levels in the non EUGR group was obviously increased and significantly higher than that of the EUGR group （p 〈 0.05）. The level of IGF- Ⅰ in both groups keep unchanged during two weeks （P〉0.05）. Conclusion： The lower levels of serum adiponectin, IGF- Ⅰ and PA were closely related to the EUGR of preterm infants, which could be used as biochemical indexes to early diagnosis of EUGR.