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目的探讨不同生长速度极低出生体质量儿(VLBW)生后早期的血清胰岛素样生长因子(IGF-1)水平变化。方法监测早产VLBW新生儿不同日龄(出生时和生后第7、14、28天)的体质量、身长、头围和体质指数(BMI),计算日均体质量增长速度(WG),并应用放射免疫分析法检测相应日龄的血清IGF-1、IGFBP-3水平,计算IGF-1/IGFBP-3摩尔比率。将具有相同营养摄入量(包括蛋白质和热卡摄入量)的52例早产VLBW适于胎龄新生儿,根据个体生后28天的不同WG水平分为低水平组和高水平组,各26例。结果 (1)在生后第28天,低水平组体质量、BMI均低于高水平组(P<0.05);而两组身长、头围水平在生后几个时间点(出生时和生后第7、14、28天)的组间差异均无显著性。(2)两组IGF-1、IGFBP-3水平出生后随日龄变化差异均有显著性(P均<0.05),都于生后第14天高于出生时水平(P<0.05);且在生后第14天时,低水平组IGF-1低于高水平组(P<0.05),而两组IGFBP-3水平在生后几个时间点(出生时和生后第7、14、28天)的组间差异均无显著性。(3)两组IGF-1/IGFBP-3水平出生后随日龄变化差异均有显著性(P<0.05或P<0.01),低水平组生后几个时间点基本维持在出生时水平,而高水平组于生后第14天高于出生时水平(P<0.05);且在生后第7、14、28天低水平组都低于高水平组(P<0.05)。结论 IGF-1可能是VLBW新生儿早期生长较好的检测指标。
Objective To investigate the changes of serum insulin-like growth factor (IGF-1) levels in early postnatal period with very low birth weight (VLBW). Methods The body mass, body length, head circumference and body mass index (BMI) of neonates with preterm VLBW at different ages (birth and days 7, 14, and 28) were measured and the average daily body mass growth rate Serum IGF-1, IGFBP-3 levels were measured by radioimmunoassay and the molar ratio of IGF-1 / IGFBP-3 was calculated. 52 preterm VLBWs with the same nutritional intake (including protein and caloric intake) were suitable for gestational age newborns and were divided into low and high groups according to different WG levels at 28 days after birth 26 cases. Results (1) On the 28th day after birth, body mass and BMI of the low-level group were lower than those of the high-level group (P <0.05) After the first 7,14,28 days) were no significant differences between groups. (2) The levels of IGF-1 and IGFBP-3 in the two groups were significantly different with the age at birth (all P <0.05), both of which were higher than those at birth (P <0.05) At the 14th day after birth, IGF-1 in low-level group was lower than that in high-level group (P <0.05), and IGFBP-3 levels in both groups were significantly higher than those in control group at birth and 7th, Day) were no significant differences between groups. (3) There were significant differences in the changes of IGF-1 / IGFBP-3 levels between the two groups at birth (P <0.05 or P <0.01). The low level group maintained at the time of birth at several time points, On the 14th day after birth, the high-level group was higher than the high-level group (P <0.05), and the low-level group was lower than the high-level group on the 7th, 14th and 28th day after birth (P <0.05). Conclusion IGF-1 may be a good indicator of early neonatal growth in VLBW.