生长激素及胰岛素样生长因子-Ⅰ对新生儿生长发育调控的观察

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目的 探讨生长激素 (GH)、胰岛素样生长因子 Ⅰ (IGF Ⅰ )在新生儿期的变化及对新生儿体格发育的影响。方法  5 6例新生儿分成 3组 :A组 (18例 )为早产适于胎龄儿 ;B组 (18例 )为早产小于胎龄儿 ;C组 (2 0例 )为足月适于胎龄儿。各组新生儿按生理需要量满足营养供给 ,分别在生后 3d内、30d时抽取股静脉血检测血GH、IGF Ⅰ水平及血糖值。结果 出生时血IGF Ⅰ水平足月儿大于早产儿 ,早产适于胎龄儿大于早产小于胎龄儿 ,3组间比较均有非常显著性差异 (P均 <0 0 0 1) ,血IGF Ⅰ值与出生体重及胎龄均呈正相关 (P分别 <0 0 0 1,<0 0 1) ;血GH值早产儿略大于足月儿 ,3组间比较无显著性差异 ,GH值与出生体重、胎龄均无相关性(P均 >0 .0 5 )。至生后 30d时血IGF Ⅰ值各组均较出生时明显增加 (P均 <0 0 0 1) ,血IGF Ⅰ的增长值与体重的增长值呈正相关 (P <0 0 1) ;GH值较出生时稍下降 ,差别无统计学意义。出生时血IGF Ⅰ与GH无相关性(P >0 0 5 ) ,30d时血IGF Ⅰ与GH弱相关 (P <0 .0 5 )。各组新生儿抽血同期血糖值均在正常范围。结论 IGF Ⅰ是胎儿发育的主要调控因子 ,也是新生儿期发育的主要调控激素。至生后 30d时 ,GH IGF Ⅰ轴的调控已基本形成。 Objective To investigate the changes of growth hormone (GH) and insulin - like growth factor Ⅰ (IGF Ⅰ) during the neonatal period and their effects on the physical development of neonates. Methods Sixty-six newborns were divided into three groups: group A (18 cases) was premature for gestational age; group B (18 cases) was premature for gestational age; group C (20 cases) Age children. Neonates of each group were fed with nutrient supply according to their physiological requirements. Blood samples were collected from the femoral venous blood at 3 days and 3 weeks after birth to measure the levels of GH, IGF Ⅰ and blood glucose. Results The level of IGF Ⅰ at birth was higher than that of full - term infants in term infants, premature infants of gestational age was higher than those of premature infants and infants less than gestational age, and there were significant differences among the three groups (all P <0.01) The values ​​were positively correlated with birth weight and gestational age (P <0 0 01, <0 0 1 respectively). Blood GH was slightly higher in premature infants than in full-term infants, and there was no significant difference between the 3 groups , Gestational age were no correlation (P> 0.05). The levels of serum IGF - Ⅰ in each group were significantly higher than those at birth (P <0 01) at 30th day after birth, and the growth of IGF Ⅰ was positively correlated with the growth of body weight (P <0.01). The GH Slightly lower than at birth, the difference was not statistically significant. There was no correlation between IGF Ⅰ and GH at birth (P> 0.05), and IGF Ⅰ was weakly correlated with GH at 30 days (P <0.05). Blood glucose in the same period of newborns in each group were within the normal range. Conclusion IGF Ⅰ is a major regulator of fetal development and also a major regulator of development during the neonatal period. 30 days after birth, GH IGF Ⅰ axis regulation has been basically formed.
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