小于胎龄儿的血清低胰岛素样生长因子I和C肽水平  

Lower serum levels of insulin like growth factor I and C-peptide in the newborns small for gestational age

作　　者：肖昕[1] 冯泽康[1] 张宁[2] 周晓光[3] 

机构地区：[1]暨南大学医学院附属第一医院儿科,广州510632 [2]广州市第六人民医院儿科 [3]广东省妇幼保健院新生儿科

出　　处：《中华内分泌代谢杂志》2000年第1期38-42,共5页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的　动态观察轻度和重度小于胎龄儿 (SGA)血清胰岛素样生长因子 I(IGF I)和C肽 (CP)水平 ,并与适于胎龄儿 (AGA)的水平进行比较 ,以探讨SGA的可能发病机制。方法　用放射免疫分析法测定了SGA和AGA出生时脐血、生后 3～ 7天和 2 2～ 2 8天外周血IGF I和CP浓度。结果　 (1)AGA出生时、出生后 3～ 7天和 2 2～ 2 8天的IGF I水平无明显差异 ,分别为 (10 .7± 4.5 )、(10 .8± 3.5 )和 (11.1± 3.4)nmol/L ;出生时和出生后 3～ 7天的CP水平相似〔(0 .43± 0 .13)和 (0 .41± 0 .12 )nmol/L〕 ,于出生后 2 2～ 2 8天下降〔(0 .32± 0 .11)nmol/L〕。 (2 )重度和轻度SGA出生时的IGF I〔(6 .1± 1.8)和 (8.9± 2 .8)nmol/L〕和CP〔(0 .2 6± 0 .0 9)和 (0 .33± 0 .11)nmol/L〕水平均低于AGA出生时水平 ;重度SGA出生后 3～ 7天和 2 2～ 2 8天的IGF I〔(6 .8± 2 .4)和 (6 .6± 1.9)nmol/L〕和CP〔(0 .2 7± 0 .10 )和 (0 .2 5± 0 .12 )nmol/L〕水平仍相当于其出生时水平 ;轻度SGA出生后IGF I和CP水平则明显上升 ,于 1周内达到AGA水平〔(11.4± 3.4)和 (0 .41± 0 .11)nmol/L〕 ,3～ 4周超过AGA水平〔(14.0± 3.5 )和 (0 .40± 0 .14)nmol/L〕。 (3)AGA出生时、出生后 3～ 7天和 2 2～ 2 8天的IGFObjective The changes in the serum levels of insulin like growth factor I (IGF I) and C peptide (CP) in the newborns small for gestational age (SGA) and appropriate for gestational age (AGA) were investigated and compared in order to make an inquiry into the effect of insulin and IGF Ⅰ on fetal/neonatal growth and development. Methods IGF Ⅰ and CP levels in the umbilical cord blood at delivery and in the peripheral blood at postnatal age of 3～7 and 22～28 days were determined by radioimmunoassay. Results (1)In AGA newborns, there was no difference in IGF Ⅰ levels at birth, 3～7 and 22～28 days of life,theywere(10.7±4.5),(10.8±3.5)and(11.1±3.4)nmol/L respectively. CP level at birth 〔(0.43±0.13)nmol/L〕 was similar to that at postnatal age of 3～7 days 〔(0.41±0.12)nmol/L〕, and CP level was decreased at postnatal age of 22～28days 〔(0.32±0.11)nmol/L〕. (2)In contrast with AGA newborns, IGF Ⅰ and CP levels in SGA neonates (mild and severe) were lower than those at birth. At postnatal age of 3～7 and 22～28 days, the severe SGA infants had still a low IGF Ⅰ and CP concentrations, whereas in mild SGA infants, their IGF Ⅰ and CP levels reached the levels of AGA infants in one week, and exceeded the levels of AGA infants in three weeks. (3)There was a positive correlation between IGF I and CP concentration in AGA infants at delivery, 3～7 and 22～28 days of life. A positive correlation between IGF Ⅰ and CP levels at 3～7 and 22～28 days of life was revealed in the mild SGA infants. No correlation between IGF Ⅰ and CP levels existed in the severe SGA infants at any time. Conclusion A transient lower IGF Ⅰ and CP concentrations exist in the mild, and a continuous lower IGF Ⅰ and CP levels exist in severe SGA infants. Lower IGF Ⅰ and CP level might result in fetal or neonatal growth retardation.

关 键 词：C肽 低体重儿 IGF-Ⅰ 

分 类 号：R722.1[医药卫生—儿科]