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目的 探讨胰岛素样生长因子结合蛋白3(IGFBP3)与胎儿宫内生长的关系,及其在胎儿宫内生长迟缓(IUGR)发病中的作用,从而对IUGR的病因作进一步的探讨。方法 选取20例分娩IUGR儿、10例分娩巨大儿及20例正常产妇,分娩后抽取母静脉血及脐静脉血,分离血清(各组产妇均无产科及内外科合并症)。用免疫放射法测定血清中IGFBP-3的浓度。结果 ①母血IGFBP-3浓度显著高于脐血(P<0..01),且二者之间无相关关系(r=-0.18,P>0.05)。②脐血中IGFBP-3浓度在IUGR组显著低于对照组(P<0..01),但巨大儿组与对照组之间无显著差别(P>0..05),脐血IGFBP-3的浓度与新生儿出生体重及胎盘重量呈正相关关系(r=0.63,r=0.48,P均<0..01)。③各组母血中IGFBP-3浓度无明显差别(P>0..05)。结论 ①母血及脐血IGFBP-3的来源不同,母血中的IGFBP-3不能通过胎盘屏障。②胎儿自身分泌的IGFBP-3与胎儿生长关系密切,其浓度降低可能是导致IUGR的重要原因之一。
Objective To investigate the relationship between insulin-like growth factor-binding protein-3 (IGFBP3) and intrauterine growth and its role in the development of intrauterine growth retardation (IUGR), so as to further explore the etiology of IUGR. Methods 20 cases of IUGR childbirth, 10 cases of giant childbirth and 20 normal pregnant women were selected. After delivery, maternal venous blood and umbilical blood were collected and serum was separated (no maternity and surgical complications were found in each group). Serum IGFBP-3 concentrations were measured by immunoradiometric assay. Results ① The level of IGFBP-3 in maternal blood was significantly higher than that in umbilical cord blood (P <0..01). There was no correlation between them (r = -0.18, P> 0.05). ② The concentration of IGFBP-3 in umbilical cord blood in IUGR group was significantly lower than that in control group (P <0..01), but there was no significant difference between macrosomia group and control group (P> 0.05) 3 was positively correlated with birth weight and placental weight (r = 0.63, r = 0.48, P <0..01). ③ There was no significant difference in the concentration of IGFBP-3 in each group (P> 0..05). Conclusion ① The sources of IGFBP-3 in maternal and umbilical blood are different, and IGFBP-3 in maternal blood can not pass the placental barrier. ② The fetal IGFBP-3 secreted by the fetus is closely related to the growth of the fetus. The decreased concentration of IGFBP-3 may be one of the important causes of IUGR.