巨大胎儿与相关内分泌因素探讨

The correlation between fetal macrosomia and relevant endocrine factors

目的 探讨巨大胎儿与相应内分泌之间的关系。方法 采用酶联免疫吸附法 (ELISA)测定 62例巨大胎儿的垂体泌乳素、雌激素、孕激素及空腹血糖水平 ,并与同期对照组 60例进行比较。结果 巨大胎儿组垂体泌乳素为 ( 15 6.7± 3 7.5 )ng ml ,对照组 ( 114 .6± 43 .4)ng ml ,差异非常显著 ( P <0 .0 1) ;雌激素为 ( 5 10 .7± 161.8)pg ml ,对照组 ( 3 99.0± 10 6.6)pg ml ,差异亦有显著性 (P <0 .0 1)。孕激素巨大儿组为 ( 4 .6± 5 .0 )ng ml,对照组为 ( 2 .2± 0 .4)ng ml ,差异亦有显著性 (P <0 .0 1) ;空腹血糖为( 3 .7± 0 .5 8)mmol L ,对照组为 ( 2 .9± 1.1)mmol L ,差异非常显著 (P <0 .0 1)。结论 巨大胎儿的发生可能与高水平催乳素和高水平雌激素有关 ,通过发挥胎盘催乳素及蜕膜催乳素作用而增加血管内皮生长因子的表达和胰岛素样生长因子的表达及增加胎盘 子宫血流量 。

Objective To investigate the correlation between fetal macrosomia and relevant endocrine foctors.Methods The prolactin,estrogen,progesterone and blood sugar before meal were detected by ELISA in 62 fetal macrosomia,which were compared with those in control group consisting of 60 normal subjects.Results The prolctin level of fetal macrosomia (156.7±37.5) ng/ml was much higer than that in control group (114.6±43.4) ng/ml (P<0.01);estrogen level (510.7±161.8) pg/ml was significantly higher than that in control group (399.0±106.6) pg/ml (P<0.01) and blood sugar level before meal (3.7±0.58) mmol/L was also much higher than that in control group (2.9±1.1) mmol/L (P<0.01).Conclusion Fetal macrosomia is probably the result of high level of prolactin and estrogen.Human placental lactogen and decidual preoactin are actived to stimulate vascular endothelial growth factor and insulin like growth factor in the blood vessel and increase the blood flow in the placenta and uterus,as a result,embryos overgrow into fetal macrosomia.