足月小于胎龄儿生后24小时内类胰岛素样生长因子1及血脂水平研究  

Investigation on the IGF-1 and lipid level in term small for gestational age infants within 24 hours postnatally

作　　者：何慧 聂川[2] 李兵[3] 郭勇 邓智 罗先琼[1] He Hui;Nie Chuan;Li Bing;Guo Yong;Deng Zhi;Luo Xianqiong(Department of Child Heath,Guangdong Women and Children Hospital,Guangzhou 511400,China;Department of Neonatology,Guangdong Women and Children Hospital,Guangzhou 511400,China;Department of Propaganda and Education,Guangdong Women and Children Hospital,Guangzhou 511400,China;Department of Pediatrics,Guangdong Women and Children Hospital,Guangzhou 511400,China)

机构地区：[1]广东省妇幼保健院儿童保健科,广州511400 [2]广东省妇幼保健院新生儿科,广州511400 [3]广东省妇幼保健院宣教科,广州511400 [4]广东省妇幼保健院儿科,广州511400

出　　处：《中华新生儿科杂志（中英文）》2022年第6期530-534,共5页Chinese Journal of Neonatology

基　　金：广州市科技计划项目(201904010459)。

摘　　要：目的探讨足月小于胎龄儿(small for gestational age infant, SGA)生后24 h内类胰岛素样生长因子1(insulin-like growth factors-1, IGF-1)与血脂水平的相关性。方法选择2020年5月至2021年1月广东省妇幼保健院分娩、生后24 h内收入新生儿病房的单胎活产SGA及适于胎龄儿(appropriate for gestational age infant, AGA)进行前瞻性研究, 将纳入患儿分为SGA组和AGA组, 比较两组患儿生后24 h内IGF-1和血脂水平的差异, 分析IGF-1与血脂的相关性。结果共纳入SGA组95例, AGA组84例。SGA组IGF-1<25 ng/ml比例高于AGA组(P<0.05)。在不同性别构成组内、早期足月分娩及完全足月分娩组内, SGA IGF-1<25 ng/ml比例也均高于AGA;SGA组甘油三酯(triglyceride, TG)水平高于AGA组, 高密度脂蛋白胆固醇(high density lipoprotein cholesterol, HDL-C)水平低于AGA组(P<0.05);SGA和AGA生后24 h内IGF-1水平与HDL-C水平成正相关(P<0.01), 与TG水平成负相关(P<0.01), HDL-C水平是IGF-1的预测因素。结论与AGA相比, SGA生后24 h内即呈现IGF-1、HDL-C分泌不足及高TG水平的状态;生后应及时予SGA营养支持, 避免发生低血糖, 并刺激IGF-1的分泌。Objective To study the insulin-like growth factors-1(IGF-1)and lipid level of term small for gestational age(SGA)infants within 24 hours postnatally and to explore the correlation between IGF-1 and blood lipids.Methods A prospective study was conducted on singleton term SGA and appropriate for gestational age infant(AGA)who were delivered and admitted to the neonatal ward of Guangdong Women and Children Hospital within 24 hours after birth from May 2020 to January 2021,and the infants were divided into SGA and AGA groups to compare the differences in IGF-1 and lipid levels within 24 hours after birth and to analyze the correlation between IGF-1 and lipids.Results A total of 95 cases in the SGA group and 84 cases in the AGA group were included in the study.The proportion of infants with IGF-1<25 ng/ml was significantly higher in SGA group(87.4%)than in the AGA group(52.4%).It was also found that the proportion of infants with IGF-1<25 ng/ml in SGA was significantly higher than that in AGA within different gender composition groups,early-term and full-term births groups.The triglyceride(TG)level was higher in the SGA group than that in the AGA group,but the high-density lipoprotein cholesterol(HDL-C)level was lower than that in the AGA group(P<0.05).IGF-1 level within 24 hours postnatally in SGA and AGA was positively correlated with HDL-C levels(P<0.01)and negatively correlated with TG(P<0.01),and HDL-C level was a predictor of IGF-1.Conclusions Compared with term AGA,SGA term infants showed insufficient IGF-1 and HDL-C secretion and high TG within 24 hours after birth.Nutritional support for SGA should be given promptly after birth to avoid hypoglycemia and to stimulate IGF-1 secretion.

关 键 词：婴儿 小于胎龄 足月妊娠 类胰岛素样生长因子1 代谢 

分 类 号：R714.5[医药卫生—妇产科学]