胰岛素样生长因子I、视黄醇结合蛋白和前白蛋白在新生儿营养评价中的意义

摘要

目的寻找新生儿营养评价的生化指标。方法以放射免疫分析试验测定血清胰岛素样生长因子I（IGF-Ⅰ）、以酶联免疫吸附试验测定视黄醇结合蛋白（RBP）和前白蛋白（PA），分别按营养状况、小于胎龄儿（SGA）和适于胎龄儿（AGA）进行分组比较。结果24例营养不良SGA的IGF-Ⅰ、RBP和PA的水平分别为(80±14)μg/L、(21±7)μg/L和(35±24)mg/L，显著低于25例营养正常SGA的(95±28)μg/L、(29±14)mg/L和(65±34)mg/L（P<0.05～0.001）；19例营养不良AGA相应的(81±17)μg/L、(25±12)mg/L和(107±17)mg/L也显著低于16例营养正常AGA的(100±32)μg/L、(32±8)mg/L和(198±68)mg/L(P<0.05～0.001)。结论IGF-Ⅰ、RBP和PA可作为新生儿营养评价的生化指标，其敏感性高、不受胎龄和日龄影响，便于疗效评价，是诊断营养不良时形态指标无法代替的。两类指标联合应用才能使诊断更完善。%Objective To look for biochemical indexes of nutritionalassessment in the newborn. Methods Insulin-like growth factor-Ⅰ(IGF-Ⅰ) in serum of the neonate was measured by radioimmunoassay(RIA). Retinol-binding protein(RBP) and Prealbumin(PA) were measured by enzyme linked immunosorbent assay (ELISA). The results were compared to different nutritional status. Results The levels of IGF-Ⅰ,RBP and PA in the group of 24 malnutritional SGAs,(80±14) μg/L,(21±7) mg/L and (35±24) mg/L，were significantly lower then that of 25 SGAs with normal nutrition,(95±28) μg/L, (29±14) mg/L and (65±34)mg/L;(P<0.05, 0.05, 0.001). The levels of IGF-Ⅰ, RBP and PA in the group of 19 mulnutritional, AGAs (87±17) μg/L, (25±12)mg/L and (107±17) mg/L were also siginificantly lower then that of 16 with normal nutrition,AGAs (100±32)μg/L, (32±8) mg/L and (198±68) mg/L;(P<0.05,0.05,0.001). Conclusion IGF-Ⅰ, RBP and PA,which can be used in evaluating the healing effect of malnutrition and can't be affected by the gestational age and postnatal age, are the sensitive biochemical indexes of nutritional assessment in newborn. Biochemical measurement can't substituted by anthropometric measurement when making diagnosis of neonatal malnutrition. In order to make the diagnosis more effective, two kinds of measurements should be done at the same time.