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目的进一步探讨IGFs及IGFBP-3与胎儿生长发育之间的关系,及其在FGR发病中的作用,以期寻找到可用于FGR早期预测和诊断的有效辅助指标。方法分别采集确诊FGR组、正常对照组孕妇羊水、肘静脉血和胎儿脐血标本,采用放射免疫法分别测定其中胰岛素样生长因子-Ⅰ、胰岛素样生长因子-Ⅱ、胰岛素样生长因子结合蛋白-3含量。结果 1.FGR组IGF-Ⅰ、IGF-Ⅱ水平在脐血清、母血及羊水标本中均明显下降;2.IGFBP-3含量在脐血和羊水中明显上升,但在母血中无显著差异;3.新生儿脐血清IGF-Ⅰ、IGF-Ⅱ水平与新生儿出生体重、身长、胎盘重量呈明显正相关关系,脐血清IGFBP-3水平与胎龄、新生儿出生体重、身长、胎盘重量呈明显正相关关系;4.脐血清IGF-Ⅰ与IGFBP-3水平与产妇产前体重呈明显正相关关系,IGF-Ⅱ水平与产妇产前体重呈正相关关系。结论脐血清IGF-Ⅰ、IGF-ⅡI、GFBP-3水平可作为预测胎儿和胎盘生长发育情况的参考指标,IGF-Ⅰ水平是其中最灵敏的指标;IGF-Ⅰ、IGF-ⅡI、GFBP-3水平的降低可能是导致FGR的重要原因之一。
Objective To further explore the relationship between IGFs and IGFBP-3 and fetal growth and development and their role in the pathogenesis of FGR in order to find effective adjuvant markers that can be used in the early prediction and diagnosis of FGR. Methods Fetal amniotic fluid, cubital vein blood and fetal umbilical cord blood were collected from FGR group and normal control group respectively. The levels of insulin - like growth factor - Ⅰ, insulin - like growth factor - Ⅱ, insulin - like growth factor binding protein - 3 content. The levels of IGF-Ⅰ and IGF-Ⅱ in FGR group were significantly decreased in umbilical serum, maternal blood and amniotic fluid samples; 2.IGFBP-3 levels in cord blood and amniotic fluid were significantly increased, but there was no significant difference in maternal blood ; ③Neonatal umbilical serum IGF-Ⅰ, IGF-Ⅱ levels and birth weight, body length, placental weight was positively correlated, umbilical serum IGFBP-3 levels and gestational age, newborn birth weight, body length, weight of placenta There was a significant positive correlation between IGF-I and IGFBP-3 levels in maternal serum and prenatal body weight. There was a positive correlation between IGF-II level and prenatal body weight. Conclusion The levels of IGF-Ⅰ, IGF-ⅡI and GFBP-3 in umbilical cord serum can be used as reference indexes to predict the growth and development of fetus and placenta. IGF-Ⅰ level is the most sensitive index among them; The level of reduction may be one of the important reasons leading to FGR.