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目的探讨高胆红素血症(高胆)早产儿血清胰岛素样生长因子-1(IGF-1)水平的变化及其临床意义。方法应用电化学发光免疫法检测64例高胆早产儿(实验组)和20例非高胆早产儿(对照组)血清IGF-1、神经元烯醇化酶(NSE)水平,同步测定其血清总胆红素(TSB)水平,并比较组间IGF-1、NSE、TSB水平的差异及其相关性。高胆组按TSB 170～256μmol.L-1,257～342μmol.L-1,>342μmol.L-1分为轻、中、重3组。结果轻、中、重高胆早产儿血清IGF-1水平分别为(25.38±5.42)μg.L-1、(21.77±8.65)μg.L-1、(18.34±4.05)μg.L-1,较对照组[(27.14±3.72)μg.L-1]明显降低,轻、中、重高胆组间IGF-1水平存在统计学差异(Pa<0.01),其值随着胆红素水平变化而变化;高胆组NSE水平分别为(25.01±2.26)μg.L-1、(30.45±2.74)μg.L-1、(33.76±5.02)μg.L-1,明显高于对照组[(11.14±4.68)μg.L-1](P<0.01),各组间差异均有统计学意义(Pa<0.01);血清IGF-1水平与TSB、NSE均呈负相关(r=-0.562、-0.503,Pa<0.01)。结论 IGF-1与高胆早产儿的预后密切相关,可作为判断高胆早产儿是否存在脑损伤的生化指标之一。
Objective To investigate the changes of serum insulin-like growth factor-1 (IGF-1) in hyperbilirubinemia (hypercholesterolemia) preterm infants and its clinical significance. Methods The levels of serum IGF-1 and neuron enolase (NSE) in 64 cases of hyperbilirubinemia (experimental group) and 20 cases of non-hyperbilirubinemia preterm infants (control group) were detected by electrochemiluminescence immunoassay. Bilirubin (TSB), and to compare the differences of IGF-1, NSE and TSB between the two groups and their correlation. The group with high gallbladder was divided into mild, moderate and severe groups according to TSB 170 ~ 256μmol.L-1,257 ~ 342μmol.L-1 and> 342μmol.L-1. Results Serum levels of IGF-1 in preterm infants with mild, moderate, severe hypercholesterolemia were (25.38 ± 5.42) μg.L-1, (21.77 ± 8.65) μg.L-1and (18.34 ± 4.05) μg.L- Compared with control group [(27.14 ± 3.72) μg.L-1], the level of IGF-1 in gallbladder group was significantly lower than that in control group (P <0.01) (25.01 ± 2.26) μg.L-1, (30.45 ± 2.74) μg.L-1 and (33.76 ± 5.02) μg.L-1, respectively, which were significantly higher than those in the control group [( 11.14 ± 4.68) μg.L-1] (P <0.01). There was a significant difference between each group (Pa0.01). Serum IGF-1 level was negatively correlated with TSB and NSE (r = -0.562, -0.503, Pa <0.01). Conclusion IGF-1 is closely related to the prognosis of preterm infants with hyperbilirubinemia and may be used as one of the biochemical markers for judging the brain damage in preterm infants with hyperbilirubinemia.