胰岛素样生长因子-1在新生儿高胆红素血症中的变化及意义

目的：胰岛素样生长因子-1(IGF-1)是神经系统必需的调节因子，目前少有报道其与高胆红素血症之间的关系。该文主要通过测定高胆红素血症（高胆）新生儿血清中IGF-1水平及新生儿神经行为评分(NBNA)来探讨IGF-1与高胆的关系及其临床意义。方法：应用电化学发光分析法检测57例高胆新生儿和 25例正常新生儿血清中IGF-1 浓度，同步测定血清总胆红素(TSB)、未结合胆红素(USB)及白蛋白(ALB)含量，计算USB与ALB比值(B/A)，并行新生儿 NBNA 评分。高胆组按血清TSB值221~256 μmol/L，257~342 μmol/L，＞342 μmol/L分为轻、中、重三组；对照组TSB ＜85 μmol/L。结果：轻、中、重高胆患儿血清IGF-1浓度均值分别为39.38±8.42，30.77±4.65，26.34±2.05 ng/L，较对照组50.16±15.73 ng/ L明显降低,在轻、中、重高胆组间IGF-1浓度差异存在显著性(P＜0.01)，其值随着胆红素的升高而降低；轻、中、重高胆组NBNA评分均值分别为35.01±2.26，32.45±2.74，26.77±5.02，明显低于对照组38.24±0.78(P＜0.01)，高胆各组间差异也有显著性(P＜0.01);血清IGF-1 浓度与NBNA评分呈正相关(r=0.603, P＜0.01)，与B/A值呈负相关(r=-0.483, P＜0.01)。结论：高胆患儿血清IGF-1浓度显著降低,降低程度与血清胆红素水平有关；IGF-1可能与新生儿胆红素脑损伤密切相关。［中国当代儿科杂志，2009，11（5）：357-360］

Serum levels of insulin-like growth factor-1 in neonates with hyperbilirubinemia

Objective Insulin-like grouth factor-1 (IGF-1) is polypetide hormone that has demonstrated effects on neural cells. Up to now,there is few reports about the relation between serum IGF-1 and brain damage in neonates with hyperbilirubinemia. This study explored the potential role of serum IGF-1 in neonatal hyperbilirubinemia.Methods Serum levels of IGF-1 were measured using ECLIA in 57 term neonates with hyperbilirubinemia and 25 normal term neonates. Meanwhile,total serum bilirubin (TSB),unconjugated bilirub...