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目的探讨小于胎龄儿(SGA)早期体质量增长速率与血清胰岛素样生长因子-1(IGF-1)、胰岛素样生长因子结合蛋白-3(IGFBP-3)分泌速率的关系。方法选取2013年9月-2015年12月在该院出生并在新生儿科住院的新生儿64例,其中SGA32例(SGA组),适于胎龄儿(AGA)32例(AGA组)。分别于生后第3、7、30天早晨8∶00~9∶00喂奶前采血,同时测量并记录体质量,采用化学发光法进行血清IGF-1、IGFBP-3水平测定。结果与生后第3天比较,两组新生儿生后第7天体质量、血清中IGF-1、IGFBP-3水平均无明显上升(P>0.05);至生后第30天时,SGA组体质量、血清中IGF-1、IGFBP-3水平明显低于AGA组(P<0.05);AGA组生后第30天时血清中IGF-1、IGFBP-3分泌速率与体质量增长速率呈显著正相关,而SGA组生后第30天时血清中IGF-1、IGFBP-3分泌速率与体质量增长速率无明显依耐性特点。结论 SGA组生后早期IGF-1、IGFBP-3的分泌水平相对较低,且分泌速率无明显体质量增长依耐性特点。SGA生后早期更需要合理充分营养以及早期干预。
Objective To investigate the relationship between the growth rate of early gestational age (SGA) and the secretion rate of serum insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) Methods Totally 64 neonates were born in this hospital from September 2013 to December 2015 and were hospitalized in neonatology. Among them, 32 cases of SGA (SGA group) and 32 cases of AGA (AGA group) were selected. Blood samples were collected before feeding on the 3rd, 7th and 30th day after birth, respectively. The body weight was measured and recorded. The levels of serum IGF-1 and IGFBP-3 were measured by chemiluminescence. Results Compared with the third day after birth, the body weight, serum IGF-1 and IGFBP-3 levels did not increase significantly on the 7th day after birth (P> 0.05) The levels of IGF-1 and IGFBP-3 in serum in AGA group were significantly lower than those in AGA group (P <0.05). The secretion rate of IGF-1 and IGFBP-3 in serum of AGA group was positively correlated with the growth rate of body weight , While the SGA group on the 30th day after birth serum IGF-1, IGFBP-3 secretion rate and body mass growth rate was not dependent on the characteristics of patience. Conclusions The secretion of IGF-1 and IGFBP-3 in SGA group is relatively low in the early postnatal period, and there is no obvious increase in body weight in the SGA group. SGA early after more rational and adequate nutrition as well as early intervention.