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目的 探讨胎儿发育受限与成人期冠心病、高血压、2型糖尿病之间的联系是否与遗传基因有关。 方法 选取小于胎龄儿75例,适于胎龄儿224 例。均进行出生测量,记录父母及祖父母是否患有2型糖尿病、冠心病、高血压(母亲糖尿病除外),并于生后第3 天测定餐前血糖和胰岛素水平。 结果 小于胎龄儿组家族中冠心病、高血压、糖尿病的发生率分别为20. 0%、30. 7%和12.0%,显著高于适于胎龄儿组的9.3%、14.7%和3.5%(P<0.01)。与家族史阴性新生儿相比,一种疾病家族史阳性时,发生小于胎龄儿的相对危险度为OR=2.788;95%CI:1.517~5.124。任意两种或三种疾病家族史均阳性时,发生小于胎龄儿的相对危险度为OR= 3. 955; 95%CI: 1. 572 ~9.951。对孕周、出生体重及产时Apgar评分校正后,家族史阳性新生儿与家族史阴性新生儿相比血糖水平差异无统计学意义(P>0.05),但胰岛素/血糖比值则明显增高(P<0.05)。 结论 遗传基因在宫内发育受限及宫内发育受限儿成人后冠心病、高血压和糖尿病的发病过程中很可能起一定作用。
Objective To investigate whether the relationship between fetal development restriction and adult coronary heart disease, hypertension and type 2 diabetes is related to genetic factors. Methods Select 75 cases less than gestational age, suitable for gestational age 224 cases. All birth measurements were taken and parents and grandparents were recorded for type 2 diabetes, coronary heart disease, and hypertension (except for maternal diabetes). Premarital glucose and insulin levels were measured on the third day after birth. Results The incidence rates of coronary heart disease, hypertension and diabetes were less than that of the gestational age group (20.0%, 30.7% and 12.0%, respectively), significantly higher than those of 9.3%, 14.7% and 3.5% % (P <0.01). Compared with negative familial history of newborns, a family history of a positive disease, the relative risk of less than gestational age was OR = 2.788; 95% CI: 1.517 ~ 5.124. 95%; 95% CI: 1. 572 ~ 9.951. The relative risk of any gestational age of any two or three disease family history was positive. There was no significant difference in blood glucose levels between gestational age, birth weight, and birth-time Apgar score (P> 0.05), but the insulin / blood glucose ratio was significantly increased (P <0.05). Conclusion The gene may play a role in the pathogenesis of coronary heart disease, hypertension and diabetes after intrauterine growth restriction and intrauterine growth restriction in children.