南方医科大学学报

南方医科大学学报 ›› 2005, Vol. 25 ›› Issue (09): 1158-1160.

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母血、羊水中胰岛素样生长因子测定及羊膜腔内给药早期诊治胎儿生长

陈海霞1, 王晓春1, 刘惠宁2, 王铁兵1   

  1. 1. 中南大学湘雅医学技术与情报学院医学检验系, 湖南, 长沙, 410013;
    2. 中南大学湘雅医院, 湖南, 长沙, 410078
  • 出版日期:2005-09-20 发布日期:2005-09-20
  • 基金资助:
    收稿日期:2005-3-12。
    基金项目:湖南省科技厅科技计划项目(01SSY2008-29;03SSY3094)
    作者简介:陈海霞(1980- ),女,硕士研究生,研究方向:临床生化与分子诊断学,E-mail:chenhx610@126.com
    通讯作者:王晓春(1955- ),女,博士,教授,硕士导师,研究方向,临床生化与分子诊断学,E-mail:W XCLX@yahoo.com.

Maternal blood and amniotic fluid insulin-like growth factor detection and amniotic cavity drug delivery for early diagnosis and management of fetal growth restriction

CHEN Hai-xia1, WANG Xiao-chun1, LIU Hui-ning2, WANG Tie-bing1   

  1. 1. 中南大学湘雅医学技术与情报学院医学检验系, 湖南, 长沙, 410013;
    2. 中南大学湘雅医院, 湖南, 长沙, 410078
  • Online:2005-09-20 Published:2005-09-20

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摘要： 目的 探讨胰岛素样生长因子(IGFs)与胎儿生长受限(FGR)的关系以及胎儿生长受限早期治疗的方法。方法 挑选FGR孕妇44例和正常孕妇36例,抽取中、晚期母血及羊膜腔穿刺术抽取羊水检测IGF-Ⅰ、IGF-Ⅱ水平。同时将44名FGR孕妇随机分为治疗组和对照组,FGR治疗组行羊膜腔内输注小儿氨基酸治疗,而FGR对照组采用孕妇静脉滴注复方氨基酸治疗,并运用多参数B超比较其疗效。结果 (1)FGR孕妇母血中IGF-Ⅰ水平、羊水中IGF-Ⅰ、IGF-Ⅱ水平显著低于同期正常孕妇(P<0.01),而两组孕妇母血中IGF-Ⅱ水平无显著性差异(P>0.05)。(2)经治疗后,FGR治疗组羊水中IGF-Ⅰ、IGF-Ⅱ水平显著升高(P<0.01),母血IGF-Ⅰ水平也明显升高(P<0.01);而FGR对照组IGF水平无明显改变(P>0.05)。(3)FGR治疗组羊水中IGF-Ⅰ、IGF-Ⅱ水平,母血IGF-Ⅰ水平较FGR对照组显著升高(P<0.01);FGR治疗组孕妇宫高、腹围,胎儿双顶径、股骨长度净增长值及新生儿出生体重均显著高于对照组(P<0.01),且治疗组胎儿出生体重接近正常水平。结论 检测母血IGF-Ⅰ及羊水中IGF-Ⅰ、IGF-Ⅱ水平可早期诊断FGR及监测胎儿宫内生长。羊膜腔内输注小儿氨基酸是治疗FGR的有效方法。

Abstract: Objective To explore the relationship between insulin-like growth factors (IGFs) and fetal growth restriction (FGR) and early treatment of FGR. Methods The levels of IGF-Ⅰ and IGF-Ⅱ were detected with radioimmunoassay in maternal blood and amniotic fluid samples of 44 pregnant women with FGR and 36 normal gravidas. The 44 gravidas with FGR were randomized into treatment group with amino acid by a pediatric administration to the amniotic cavity formula and control group with intravenous infusion of compound amino acid. The therapeutic effects were compared between the two groups on the basis of B-type ultrasound findings. Results Maternal blood IGF-Ⅰ and amniotic fluid IGF-Ⅰ and IGF-Ⅱ levels in the pregnant women with FGR were significantly lower than those in normal gravidas (P<0.01). After therapy, IGF-Ⅰ and IGF-Ⅱ levels were significantly increased in the treatment group (P<0.01), but no obvious changes in IGF-Ⅰ and IGF-Ⅱ levels were observed in the control group (P>0.05). Compared with the control group, IGF-Ⅰ and IGF-Ⅱl levels increased significantly in the amniotic fluid in the treatment group, with also marked elevation of IGF-Ⅰ levels in maternal blood (P<0.01). Better therapeutic effects were achieved in the treatment group than in the control group (P<0.01), and the birth weights of the neonates in the treatment group were basically normal. Conclusions Detection of amniotic fluid IGF-Ⅰ and IGF-Ⅱ and maternal blood IGF-Ⅰ can help predict the condition and facilitate early diagnosis of FGR. Injection of pediatric amino acid into the amniotic cavity can be effective for treatment of FGR.

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