早期干预对早产儿血清IGF-1、GH表达及生长发育的影响

目的研究早期干预对早产儿生长发育的影响及其机制。方法将60例早产儿随机分成实验组和对照组,实验组从出院开始接受早期干预,定期随访,对照组仅进行常规体检和育儿指导,于纠正胎龄3、6、12月进行生长发育指标检测,出生第3天、纠正胎龄3个月、6个月测定血清胰岛素样生长因子1（IGF-1）和生长激素（GH）水平,1岁时所有患者行神经系统检查,计算两组脑瘫发生率。结果实验组体重明显重于对照组,身长明显长于对照组（P〈0.01）。实验组智能发育指数（MDI）及运动发育指数（PDI）高于对照组（P〈0.01）。3个月时实验组血IGF-1水平明显高于对照组（P〈0.01）,而血GH水平与对照组差异无显著性（P〉0.05）。6个月时实验组血IGF-1和GH水平明显高于对照组（P〈0.01）。1岁时实验组脑瘫发生率明显低于对照组（P〈0.05）。3月龄早产儿血IGF-1水平与体重、身长呈正相关（P〈0.05）,与MDI、PDI无相关性（P〉0.05）。而血GH水平则与体重、身长、MDI和PDI无相关性（P〉0.05）。6月龄早产儿血IGF-1、GH水平与体重、身长、MDI、PDI呈正相关（P〈0.05）。3月龄时两组早产儿血IGF-1与GH水平之间无相关性（r=0.11,P=0.41）,6月龄时血IGF-1与GH水平之间有相关性（r=0.50,P=0.00）。结论早期干预能促进血清IGF-1、GH水平提高,从而促进中枢神经系统及体格发育。IGF-1是生后早期调控生长发育的主要激素。GH-IGF-1轴可能在6月龄时已经形成。

The Effects of Early Intervention on Premature Infants Development and the Serum Levels of Insulin-Like Growth Factor-1 and Growth Hormone

Objective To study the effects of early intervention on premature infants development and its possible mechanism. Methods 60 cases of survived premature infants were randomly divided into 2 groups: experimental group(30 cases) and control group(30 cases).The experimental group were discharged form hospital,and received early intervention.In control group,infants just received similar routine care.At the age of 3 months,6 months,and 12 months,mental development index and psychomotive development index, heigh...