IGF-1在妊娠期糖尿病胎盘组织中的表达及其对新生儿心功能影响的探讨  

The expression of IGF-1 in the placenta of gestational diabetes and its impact on heart function of newborn

作　　者：汤栩文 崔咏怡 林斯 谢晓斌[2] 

机构地区：[1]广州市妇女儿童医疗中心妇婴院区妇产科,广东广州510180 [2]广州医学院病理教研室

出　　处：《中国优生与遗传杂志》2011年第2期62-64,F0003,共4页Chinese Journal of Birth Health & Heredity

摘　　要：目的探讨胰岛素样生长因子-1(Insulin-like growth factor-1,IGF-1)在妊娠期糖尿病(gestational dia-betes mellitus,GDM)胎盘组织中的表达以及其与GDM胎盘病理改变、新生儿心功能异常的关系。方法在妊娠期糖尿病孕妇中,前瞻性按照病例入选标准收集血糖控制欠佳的孕妇80例作为控制欠佳组,收集血糖控制良好的孕妇80例作为控制良好组,随机选取正常妊娠孕妇80例为对照组。于胎儿、胎盘娩出后,在胎盘的中央带取材,经固定、脱水、包埋、切片后,行IGF-1免疫组织化学染色。新生儿行超声心动图测量心脏相关指标,并抽血查心肌酶五项。结果 IGF-1在GDM血糖控制欠佳组胎盘中阳性细胞表达强度明显高于正常对照组及血糖控制良好组(P<0.05);而血糖控制良好组的IGF-1阳性细胞表达强度与对照组比较无统计学意义。胎盘IGF-1阳性表达强度高的孕妇所分娩的新生儿出现心肌酶五项升高的发生率高于IGF-1阳性表达强度低的孕妇所分娩的新生儿,P<0.001;胎盘IGF-1阳性表达强度高的孕妇所分娩的新生儿超声心动图表现为室间隔的肥厚、心室和大动脉收缩血量的增加、心室舒张功能的受损,与对照组相比P<0.001。结论 GDM孕妇血糖控制欠佳时,IGF-1在胎盘组织中呈高阳性表达,所分娩的新生儿出现心肌酶谱受损的发生率升高,心脏解剖和功能异常的发生率升高。Objective：To study the expression of insulin-like growth factor-1 in the placenta of gestational diabetes,and its pathology with GDM,the relationship between neonatal heart dysfunction.Methods：In cases of gestational diabetes mellitus,Forward-looking cases selected according to the standard collection were divided into poor control group（80cases） and better control group（80cases）,80 cases of normal pregnancy women as controls.After the fetus and placenta delivery,in the central zone of placenta derived,After fixation、dehydration、embedding、slicing,the line IGF-1 immunohistochemistry.Neonatal echocardiography measurement of cardiac-related indicators,and check blood enzyme 5.Results：Intensity of IGF-1 positive cells in the placenta GDM poor blood glucose group was significantly higher than control group and the better blood glucose control group（P0.05）;The better blood glucose control group intensity of IGF-1 positive cells compared with control group without statistical significance.IGF-1 expression in the placenta showed high rates of the newborns appeared five enzymes in the high incidence of elevated IGF-1 showed low expression rate in newborns,P0.001;IGF-1 expression in the placenta showed high rates of newborns by echocardiography showed septal hypertrophy、ventricular and aortic systolic blood volume increase、impaired ventricular diastolic function,Compared with the control group,P0.001.Conclusions：Poor blood glucose control when GDM pregnancy women,IGF-1 in the placenta and the expression of the positive rate was high,the newborns appeared higher incidence of impaired myocardial enzymes,Cardiac anatomy and function of the incidence of abnormal increased.

关 键 词：IGF-1 妊娠期糖尿病 胎盘 新生儿 心功能 

分 类 号：R714.25[医药卫生—妇产科学]