不同胎龄儿脐血IGF-1、IGFBP-1及CP水平的变化

目的 了解胰岛素样生长因子-1(IGF-1)、胰岛素样生长因子结合蛋白-1(IGFBP-1)及C肽(CP)对不同胎龄新生儿出生体重的影响。方法 选取不同胎龄的新生儿共76例,按孕周分为≤32、-34、-36、-38、-40、-42周6组,均为适于胎龄儿。分娩时取脐静脉血3 ml,用EIASA法测定血清IGF-1、IGFBP-1及CP。结果 自32周至40周,血清IGF-1、CP逐渐增加,IGFBP-1逐渐下降,各组间差异有显著意义(除34与36周三者比较P>0.05外),但至42周时,IGF-1、CP开始下降,IGFBP-1上升,与40周相比,P<0.05。IGF-1、CP均与胎龄呈中度正相关,而IGFBP-1与胎龄呈高度负相关。结论IGF-1、CP能促进孕晚期胎儿宫内生长,而IGFBP-1则对胎儿生长起抑制作用。因此,营养物质-胰岛素-胰岛素样生长因子系统代谢轴是孕后期调节胎儿生长的重要系统。

THE CORD BLOOD LEVELS OF IGF - 1, IGFBP - 1 AND CP IN NEWBORNS WITH DIFFERENT GESTATIONAL AGE

Objective To explore the levels of insulin - like growth factor - 1 (IGF - 1), C -peptide( CP) and insulin - like growth factor binding protein - 1 (IGFBP - 1) in newborns. Methods 76 neonates appropriate for gestational age were selected and divided into six groups according to their gestational age, 32,34,36,38,40 or 42 week. Umbilical cord blood was collected at time of delivery for determination of IGF - 1, CP and IGFBP - 1 by ELISA. Results Cord serum IGF - 1 and CP were increased and IGFBP - 1 decreased gradually from 32 to 40 week gestational age. There were significant differences among each group (except comparison between 34 week and 36 week, P > 0.05 ) . IGF - 1 and CP was lower and IGFBP - 1 higher in newborns in 42 week than in 40 week. Gestational age was positively correlated with IGF - 1 and CP levels and negatively with IGFBP - 1. Conclusion IGF - 1 and CP might stimulate fetal growth in late pregnancy, but IGFBP - 1 may play an inverse role. So nutri tion - insulin - IGF axis might be an important system in regulation of intrauterine growth.