胰岛素样生长因子结合蛋白-3与胎儿宫内生长迟缓的关系

摘要

Objective To explore the effect of insulin-like growth factor-binding protein-3 (IGFBP-3) in the intrauterine growth retarded (IUGR). Methods Samples of maternal blood and matched umbilical cord blood were collected at time of delivery from 20 normally grown (control group) and 20 intrauterine growth retarded (IUGR group) and 10 fetal macrosonia (macrosonia group). IGFBP-3 of serum was mesured with IRMA. Results ①IGFBP-3 in maternal serum was significantly higher than that of in umbilical serum (P ＜ 0.01 ) and there was no correlation between them ( r = - 0.18, P ＞0.05); ②The IGFBP-3 level of umbilical serum in IUGR group was signifi cantly lower than that of in control group ( P＜0.01 ) , and was positively correlated with birth weight and weight of placenta ( r = 0.63 and r = 0.48, P＜0.01 ); ③There was no difference of the IGFBP-3 level in maternal serum among three groups; ④The IGFBP-3 level of umbilical serum in macrosonia group was not different from those in control group. Conclusions ①IGFBP-3 in maternal serum can't pass through the placenta;②IGFBP-3 of fetal origin may have the close relationship with the fetal development. The decrease of IGFBP-3 may be one of the reasons of IUGR.%目的探讨胰岛素样生长因子结合蛋白-3(IGFBP-3)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③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(γ=-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(γ=0．63，γ=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IG-FBP-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。