妊娠高血压综合征患者胰岛素样生长因子与胎儿发育的关系

妊娠高血压综合征患者胰岛素样生长因子与胎儿发育的关系

作者：盛霞玲

来源：《中国医药导报》2009年第19期

[摘要] 目的:探讨妊娠高血压综合征患者血清胰岛素样生长因子-1(IGF-1)和胰岛素样生长因子结合蛋白-3(IGFBP-3)水平与疾病程度及新生儿出生体重之间的关系。方法:用放射免疫方法测定40例妊娠高血压综合征患者和40例正常血压妊娠妇女的血清IGF-1及IGFBP-3水平。结果:重度妊娠高血压综合征组IGF-1显著低于正常组,IGFBP-3在各组间的水平均无显著性差异,但IGF-1与IGFBP-3呈正相关。新生儿出生体重随妊娠高血压综合征严重程度的加剧而降低,各组间比较,有显著性差异(F=5.453,P=0.002)。结论:妊娠高血压综合征患者的发病及严重程度与IGF-1明显相关,IGF-1与胎儿的发育及新生儿出生体重有明显的相关性。

[关键词] 妊娠高血压综合征;胰岛素样生长因子;胰岛素样生长因子结合蛋白-3;胎儿

[中图分类号] R714.24+6[文献标识码]A [文章编号]1673-7210(2009)07(a)-015-02

The relationship between insulin-like growth factor and fetal development in patients with pregnancy-induced hypertension syndrome

SHENG Xialing

(Department of Gynecology and Obstetrics, Huiyang Maternal and Child Health Hospital, Huiyang 516001, China)

[Abstract] Objective: To explore the relationship between levels of serum insulin-like growth factor 1(IGF-1) and insulin-like growth factor binding protein 3 (IGFBI-3) in women with pregnancy-induced hypertension syndrome (PIH) and severity of PIH as well as the neonatal birth weight. Methods: Radioimmunoassay was used to detect levels of serum IGF-1 and IGFBP-3 in 40 casess with PIH and 40 cases of normal pregnancy women. Results: The level of serum IGF-1 in severe PIH group was significantly lower than that of normal group. There was no significant difference in IGFBP-3 among groups, but there was a positive correlation between IGF-1 and IGFBP-3. The neonatal birth weight reduced with the PIH severity aggravated and there was a significant difference among groups (F=5.453, P=0.002). Conclusion: The occurrence and severity of patients with PIH are obviously related to IGF-1, and IGF-1 shows an obvious correlation with fetal development and neonatal birth weight.

[Key words] Pregnancy-induced hypertension syndrome; Insulin-like growth factor; Insulin-like growth factor binding protein 3; Neonate

胎儿的生长发育与母体营养物质的供应、胎盘功能、激素、细胞因子和生长因子等因素有关,其中胰岛素样生长因子-1(insulin-like growth factor 1,IGF-1)被认为与胎儿的生长发育密切相关。循环中的IGF-1绝大多数与胰岛素样生长因子结合蛋白-3(insulin-like growth factor binding protein 3,IGFBP-3)结合。目前的研究表明,IGFBP-3不仅仅作为IGF的载体[1-2],而且还是IGF 的活性调控因子,起抑制或增强IGF的作用[3]。本研究旨在探讨足月妊娠妇女血清IGF-1、IGFBP-3的水平变化及其与胎儿生长发育的关系。

1 资料与方法

1.1 一般资料

收集2001年1月～2004年4月我院产科的妊娠高血压综合征患者40例进行研究。入选条件:①足月单胎妊娠、月经周期正常、孕早期经B超核对孕周;②排除糖耐量异常或糖尿病;③B 超提示胎儿无先天畸形。妊娠高血压综合征组患者平均年龄(25.9±4.3)岁,平均孕周(37.6±3.7)周。依文献[2]将40例分为3组:轻度15例,中度15例,重度10例。选择同期入院待产的正常血压晚期妊娠孕妇40例作为对照组,对照组平均年龄(26.0±2.5)岁,平均孕周(39.7±1.3)周,两组年龄、孕周无显著性差异。

1.2 测定方法

所有研究对象均于入院后抽肘静脉血4 ml,采样随即注入含30 μl 10%乙胺四乙酸和40 μl 抑肽酶的试管中,充分摇匀。标本以3 000 r/min离心10 min,取上清液置于-40℃保存待测。IGF-1和IGFBP-3采用免疫放射法,试剂盒为美国DSL公司产品,严格按照说明书操作。测量仪器为上海核福光电仪器有限公司的SN682B-γ免疫记数仪。

1.3 统计学方法

数据以均数±标准差(x±s)表示,采用SPSS 10.0对数据进行统计学处理。各组数据经方差分析后进行两两比较,双变量数据采用Pearson法,P

2 结果

2.1 各组IGF-1、IGFBP-3水平变化与组间比较分析

分析各组孕妇血清IGF-1、IGFBP-3水平发现,妊娠高血压综合征患者IGF-1水平降低,与正常对照组相比,有显著性差异;IGFBP-3水平比较,无显著性差异,见表1。