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目的通过对比羊膜腔灌注术及静脉输液分别治疗胎儿生长受限(fetal growth restriction,FGR)后母体血清、羊水及新生儿脐血中IGF-Ⅰ,Ⅱ及IGFBP-3水平的差异来阐明胰岛素样生长因子系统与FGR的关系,并为羊膜腔灌注治疗的可行性及科学性提供理论基础。方法选取2007年6月～2010年12月在广州医学院附属广州市第一人民医院产科住院的临床诊断的中期FGR孕妇60例,随机分为羊膜腔灌注治疗组30例(实验组)及静脉输液治疗组30例(对照组);分别测定两组孕妇分娩时的母血、羊水及脐血中的IGF-Ⅰ、Ⅱ及IGFBP-3的浓度并对比它们的差异;记录两组孕妇分娩时新生儿的身长、体重及胎盘重量并对比它们的差异。结果与对照组相比较,实验组的IGF-Ⅰ,Ⅱ水平有明显的上升,而IGFBP-3水平在羊水及脐血中均下降,在母血中无明显差异;实验组的新生儿身长、体重及胎盘重量明显高于对照组。结论羊膜腔灌注治疗FGR与母体静脉输注氨基酸及能量合剂治疗FGR相比较,前者是治疗FGR的更为有效的方法,可通过母血中IGF-Ⅰ及羊水中IGF-Ⅰ、Ⅱ及IFGBP-3水平的检测来评估疗效。
Objective To compare the levels of IGF-Ⅰ, Ⅱ and IGFBP-3 in maternal serum, amniotic fluid and neonatal cord blood after the treatment of fetal growth restriction (FGR) by amniotic cavity perfusion and intravenous infusion respectively to clarify the insulin-like The relationship between growth factor system and FGR, and provide theoretical basis for the feasibility and scientific of amniotic cavity perfusion therapy. Methods Sixty-six interim FGR pregnant women admitted to the First People’s Hospital of Guangzhou First People’s Hospital affiliated to Guangzhou Medical College from June 2007 to December 2010 were randomly divided into amniotic fluid perfusion group (n = 30) and experimental group (Control group). The concentrations of IGF-Ⅰ, Ⅱ and IGFBP-3 in maternal blood, amniotic fluid and umbilical cord blood of the two groups during delivery were measured and compared with each other. Neonatal length, weight and placental weight and compare their differences. Results Compared with the control group, the levels of IGF-Ⅰ and Ⅱ in the experimental group increased significantly, while the levels of IGFBP-3 in the amniotic fluid and umbilical cord blood decreased but there was no significant difference in the maternal blood. The body length, Weight and placental weight were significantly higher than the control group. Conclusion Amniotic cavity perfusion treatment of FGR and maternal intravenous infusion of amino acids and energy mixture for the treatment of FGR, the former is a more effective treatment of FGR method, through the maternal serum IGF-Ⅰ and amniotic fluid IGF-Ⅰ, Ⅱ and IFGBP- 3 levels of the test to assess the efficacy.