新生儿血清瘦素、生长激素、胰岛素样生长因子-1、胰岛素样生长因子结合蛋白-3水平与宫内发育的关系

目的 探讨瘦素(leptin)、生长激素(GH)、胰岛素样生长因子-1(IGF-1)、胰岛素样生长因子结合蛋白-3(IGFBP-3)在不同宫内发育状况胎儿中的变化,及对胎儿生长发育调控的作用.方法 2004年1月-2006年6月出生早产小于胎龄儿(A组)30例,早产适于胎龄儿(B组)36例,足月小于胎龄儿(C组)32例,足月适于胎龄儿(D组)37例.生后24 h内抽取患儿静脉血,用放射免疫法(RIA)检测其血清leptin、GH、IGF-1、IGFBP-3水平,组间比较采用及多元回归相关分析.结果 各组新生儿血清leptin、GH、IGF-1、IGFBP-3水平均存在明显差异(Pa<0.05,0.01),各指标基本呈C、A、B、D组次序由低到高,但A组IGF-1与C组差异无统计学意义(P>0.05);在A、B和C组,出生体质量与leptin、IGF-1、IGFBP-3呈正相关(Pa<0.01),而D组出生体质量与IGF-1呈正相关(P<0.01),与其他激素无相关性.结论 leptin、IGF-1、IGFBP-3参与宫内发育迟缓儿和早产儿宫内生长发育的调控.IGF-1在早产适于胎龄儿的宫内生长发育中也起调控作用,而leptin、GH、IGFBP-3均不是足月适于胎龄儿生长发育的主要调节因素.

Changes of Serum Level of Leptin,Growth Hormone,Insulin Like Growth Factor-1 and Insulin Like Growth Factor Binding Protein-3 in Different Intrauterine Growth and Development Situation

Objective To explore the relationship between the serum level of leptin,growth hormone(GH),insulin like growth factor-1(IGF-1),insulin like growth factor binding protein-3(IGFBP-3)and those modulatine effects on fetal growth.Methods One hundred and thirty-five cases of newborns were divided into 4 groups according to the relationship between born weight and gestational age.Group A:premature infants small for gestational age(SGA),n=30.Group B:premature infants appropriate for gestational age(AGA),n=36.Group C:mature infants small for gestational age,n=32.Group D:mature infants appropriate for gestational age,n=37.All infants were measured se-rum leptin,GH,IGF-1 and IGFBP-3 level with radiommunosassay(RIA).Results There were significant difference in the levels of leptin,GH,IGF-1,IGFBP-3 as group C0.05).There were positive correlation between levels of leptin,IGF-1 and IGFBP-3 in group A,B and C,while,there was positive correlation between only level of IGF-1 in group D.Conclusions Leptin,IGF-1 and IGFBP-3 may play an important role in the fetal growth regulation of premature infants and IUGR infants.IGF-1 also regulate intrauterine growth of group D.Another side,in group D,Leptin,GH,IGF-1 and IGFBP-3 don't regulate fetal growth.