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目的探讨胰岛素样生长因子-1(Insulin-like growth factor-1,IGF-1)在妊娠期糖尿病(gestational dia-betes mellitus,GDM)胎盘组织中的表达以及其与GDM胎盘病理改变、新生儿心功能异常的关系。方法在妊娠期糖尿病孕妇中,前瞻性按照病例入选标准收集血糖控制欠佳的孕妇80例作为控制欠佳组,收集血糖控制良好的孕妇80例作为控制良好组,随机选取正常妊娠孕妇80例为对照组。于胎儿、胎盘娩出后,在胎盘的中央带取材,经固定、脱水、包埋、切片后,行IGF-1免疫组织化学染色。新生儿行超声心动图测量心脏相关指标,并抽血查心肌酶五项。结果 IGF-1在GDM血糖控制欠佳组胎盘中阳性细胞表达强度明显高于正常对照组及血糖控制良好组(P<0.05);而血糖控制良好组的IGF-1阳性细胞表达强度与对照组比较无统计学意义。胎盘IGF-1阳性表达强度高的孕妇所分娩的新生儿出现心肌酶五项升高的发生率高于IGF-1阳性表达强度低的孕妇所分娩的新生儿,P<0.001;胎盘IGF-1阳性表达强度高的孕妇所分娩的新生儿超声心动图表现为室间隔的肥厚、心室和大动脉收缩血量的增加、心室舒张功能的受损,与对照组相比P<0.001。结论 GDM孕妇血糖控制欠佳时,IGF-1在胎盘组织中呈高阳性表达,所分娩的新生儿出现心肌酶谱受损的发生率升高,心脏解剖和功能异常的发生率升高。
Objective To investigate the expression of Insulin-like growth factor-1 (IGF-1) in gestational diabet of mellitus (GDM) placenta and its relationship with GDM placenta pathology, neonatal heart Abnormal relationship. Methods In pregnant women with gestational diabetes mellitus, 80 pregnant women with poor control of blood glucose were prospectively selected as the control group. 80 pregnant women with well-controlled blood glucose control were enrolled as control group. 80 pregnant women Control group. After the fetus was delivered, the placenta was taken from the center of the placenta and fixed, dehydrated, embedded and sectioned for IGF-1 immunohistochemical staining. Newborns were measured echocardiography heart-related indicators, and check the cardiac enzymes five blood. Results The positive expression of IGF-1 in the placenta of poor GDM control group was significantly higher than that of the normal control group and the well-controlled group (P <0.05), while the expression of IGF-1 positive cells in the control group was significantly lower than that in the control group No statistical significance. The incidence of five elevated myocardial enzymes in pregnant women with high expression of placental IGF-1 was higher than that in pregnant women with low expression of IGF-1, P <0.001. Placental IGF-1 Neonatal echocardiograms delivered by pregnant women with high positive expression showed ventricular septal hypertrophy, increased systolic blood volume in ventricles and aorta, and impaired ventricular diastolic function compared with the control group (P <0.001). Conclusions IGF-1 is highly expressed in placenta when glucose control is not good in GDM pregnant women. The incidence of myocardial enzyme damage and the incidence of cardiac anatomy and dysfunction in newborn infants are increased.