宫内发育迟缓儿生长相关激素水平变化及临床意义  

Changes of serum level of growth related hormone in different pathogeny intrauterine growth retardation infants and clinical value

作　　者：刘改英[1] 林广[1] 马海燕[1] 张成[1] 潘革[2] 

机构地区：[1]珠海市人民医院儿科,广东珠海519000 [2]广西医科大学第三附属医院儿科,广西南宁530022

出　　处：《中国妇幼健康研究》2013年第2期141-143,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨匀称型和非匀称型宫内发育迟缓（1UGR）儿出生时、3个月、6个月时生长激素（GH）、胰岛素样生长因子-l（IGF-1）、胰岛素样生长因子结合蛋白-3（IGFBP-3）的变化特点和生长规律。方法用放射免疫法测定匀称型30例和非匀称型32例1UGR婴儿出生时、3个月、6个月时GH、IGF-1、IGFBP-3的质量浓度。结果出生时两组婴儿IGF-1、IGFBP-3水平差异无统计学意义（t：0．7422，P〉0．05），但匀称组婴儿体重（1．772．21±180．54）、GH（7．26±1．78）水平低于非匀称组，并有统计学意义（分别为：t=2．3957，P=0．0197〈0．05和t=3．3793，P=0．0013〈0．01）。而3个月、6个月时匀称组婴儿体重与GH、IGF-1、IGFBP-3水平均低于非匀称组（t值分别为4．4720，4．9765，3．4628，2．7318和9．5716，4．5306，5．5258，6．9176，均P〈0．01），并呈^-ffn关（r=0．65、0．52、0．64和0．56、0．59，均P〈0．05，6个月时GH与体重的r=0．77，P〈0．01）；匀称组婴儿出生时、非匀称组婴儿出生时、3个月、6个月时，体重与GH、IGF-1、IGFBP-3水平均无相关性（均P〉0．05）。结论生后6个月内匀称型IUGR儿GH、IGF-1、1GFBP-3水平及生长速度低于非匀称IUGR儿，且体重与上述3种激素水平有关，而非匀称IUGR儿的体重与3种激素无相关性，为了获得较好的生长速度，对两种不同类型的IUGR儿应采取不同的干预措施。Objective To explore the level changes of growth hormone （GH）, insulin-like growth factor-1 （IGF1） and IGF-binding protein-3 （IGFBP3） in symmetry intrauterine growth retardation （IUGR） infants and non-symmetry IUGR infants from birth to 6 months and their growth characteristics. Methods The levels of GH, IGF1 and IGFBP3 of 30 infants with symmetry IUGR and 32 infants with non- symmetry IUGR were measured by radioimmunoassay （RIA） at birth, 3 months and 6 months. Results At birth there was no significant difference in levels of IGF1 and IGFBP3 between two groups （ t -- 0. 7422, P 〉 0. 05 ）. But the birth weight （ 1 772.21 ＋ 180.54） and level of GH （7.26 ＋ 1.78） in symmetry group were lower, and the differences were statistically significant （ t value was 2. 3957 and 3. 3793, respectively,P =0.0197 〈0.05 and P =0.0013 〈0.01 ）. However, the body weight, GH, IGF1 and IGFBP3 levels of symmetry group at 3 months and 6 months were lower than those of non-symmetry group （t value was 3. 625, 3. 689, 4. 201 and 3. 623, respectively at 3 months, 3. 259, 4. 235, 4. 358 and 3. 654, respectively at 6 months, all P 〈 0. O1 ）. They were positively correlated with body weight （ r = O. 795-9. 125, all P 〈 0.05, or P 〈 0.01 ）. The body weight of non-symmetry group was not correlated with levels of GH, IGF1 and IGFBP3 at birth, 3 months and 6 months （r = 0.253-0. 364, all P 〉 0.05）. Conclusion The levels of GH, IGF1 and IGFBP3 and growth rate of symmetry IUGR infants are lower than those of non-symmetry IUGR infants, and body weight is correlated with the levels in symmetry IUGR infants. But body weight is not linked to levels of GH, IGF1 and IGFBP3 in non-symmetry IUGR infants. Different intervention measures should be taken to achieve perfect physical growth according to different IUGR type.

关 键 词：宫内发育迟缓 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 

分 类 号：R172[医药卫生—妇幼卫生保健]