ghrelin与早产儿追赶生长的关系研究

目的研究血清ghrelin水平与早产儿追赶生长的关系,探讨ghrelin在早产儿追赶生长过程中的作用及作用机制。方法 2009年10月至2011年12月上海交通大学医学院附属国际和平妇幼保健院收住NICU的38例纠正胎龄37w早产儿和40例正常37w足月新生儿分别为早产组和对照组,记录两组纳入研究时、纠正胎龄1月、3月体重（分别用W1-3表示）,计算体重增长速度（△W2-3）;用ELISA方法检测早产组患儿纳入研究时血清ghrelin、生长激素（GH）、胰岛素样生长因子1（IGF-1）水平。比较早产儿组和对照组体重增长情况,比较早产儿小于胎龄儿（SGA）、适于胎龄儿（AGA）组血ghrelin、GH、IGF-1水平及体重增长情况,分析早产儿组血ghrelin、GH、IGF-1水平与W2、W3、△W2、△W3之间的相关性。结果早产儿组W1-2低于对照组,△W2-3高于对照组（P〈0.05）。早产儿组W3低于对照组（P=0.131）。早产儿SGA组W1-3以及△W2、△W3、血ghrelin水平均低于AGA组（P〈0.01）,GH、IGF-1比较无统计学意义（P〉0.05）。早产儿血ghrelin水平与W2、W3、△W2、△W3呈正相关性（P均=0.000）。IGF-1与△W3呈正相关性（P=0.047）。GH与IGF-1正相关P=0.021）。血ghrelin水平与GH、IGF-1无相关性。结论 ghrelin可能参与了早产儿追赶生长,并非通过GH-IGF-1轴发挥作用,其作用机制尚需进一步探讨。

A study on the relationship between blood ghrelin level and catch up growth in preterm neonates.

Objective： To analysis the relationship between serum ghrelin level and catch up growth in preterm neonates. And to explore the mechanisms of ghrelin playing a role in the preterm＇ s catch up growth. Methods： 38 preterm infants at 37 weeks of corrected postnatal age （CA） were included, whose birth weight lower than 2000 grams, admitted into NICU of our hospital from Oct. 2009 to Dec. 2011.40 newborns of gestational age 37 weeks were included as control group. All the babies were weighted when enrolled into the research （Wl） and at 1 month （W2） , 3 month （W3） of CA. Mean weight gain （LkW2, ~W3 ） were calculated. Serum ghrelin, GH and IGF-1 concentrations were measured by ELISA sampled at 37 weeks of CA of pteterm infants. The relationship of serum ghrlin, GH, IGF-1 and growth development parameters was investigated. Results： AW2, AW3 were significantly higher in preterm group than those in control group, although Wl, W2 were lower in preterm group and similar W3 in two groups. W1-W3, AW2, AW3, serum ghrelin levels were lower in preterm SGA than in preterm AGA. GH and IGF-1 levels were similar in the two groups. Serum ghrelin levels were positively correlated with W2, W3, △W2, △W3 （P=0. 000） . IGF-1 levels were correlated with ＆W3 and GH, but ghrelin levels were not correlated with GH and IGF-1 levels. Conclusion： Ghrelin might play a role in preterm catch up growth, but it doesn＇t influence GH-IGF-1 axis. Further studies are needed to explore the mechanisms.