摘要
目的 探讨胎儿宫内发育迟缓 (IUGR)时孕妇血清、脐血和羊水中生长激素、胰岛素及甲状腺激素的变化。方法 采用放射免疫和固相微球放射免疫法测定正常足月妊娠 4 2例 (正常组 )和足月妊娠IUGR 2 3例 (IUGR组 )孕妇血清、脐血和羊水中生长激素、胰岛素、三碘甲腺原氨酸 (T3)、甲状腺素 (T4)和促甲状腺素 (TSH)水平。结果 IUGR组孕妇血清和脐血中生长激素显著下降 (P<0 .0 1、P <0 .0 5 ) ,脐血和羊水中胰岛素水平与正常组比较 ,也明显下降 (P <0 .0 5、P <0 .0 1) ,而脐血中T4显著下降 (P <0 .0 5 ) ,TSH明显升高 (P <0 .0 1) ,T3则无明显变化。结论 生长激素分泌不足可能是IUGR发病原因之一 ,低胰岛素血症与生长激素不足并存 ,可使胎儿基础代谢率降低 ,进而导致IUGR。甲状腺功能减退可能是胎儿在不利环境中的自我保护。
Objective To investigate the relationship between intrauterine growth retardation(IUGR )and endocrine parameters and to assess the effects of the main endocrine factors on IUGR. Methods The concentrations of growth hormone (GH), insulin, triiodothyronine(T 3), tetraiodothyronine(T 4), and thyroid stimulating hormone (TSH) were measured in maternal serum, umbilical blood and amniotic fluid. The samples were collected from 23 term pregnancies with IUGR ,and 42 normal pregnancies served as control. Growth hormone and insulin were measured by radioimmunoassay,and T 3, T 4 and TSH by microradioimmunoassay. Results The concentrations of GH, insulin and T 4 in umbilical blood were lower in IUGR group than that in the normal group (IUGR: GH 4.63 μg/L vs 7.01 μg/L, insulin 10.68 mIU/L vs 31.44 mIU/L, T 4 0.68 mg/L vs 1.07 mg/L. P <0.05, 0.05, 0.05), the TSH level in umbilical blood was higher in IUGR than that in the control group (10.84 mIU/L vs 5.74 mIU/L. P <0.01). The concentration of GH in maternal serum and insulin in amniotic fluid in IUGR group were also lower than that in normal group (GH 1.77 μg/L vs 2.74 μg/L, P <0.01;insulin 5.84 mIU/L vs 15.64 mIU/L, P <0.01). Conclusions This study confirms previous observation that insufficiency of GH might be a pathogenesis of IUGR. The decrease of GH and insulin might compromise the basic metabolism of the fetus. Besides, the change of early hypothyrosis of fetus with IUGR might benefit them to live in unfavorable environment.
出处
《中华妇产科杂志》
CSCD
北大核心
2000年第1期26-28,共3页
Chinese Journal of Obstetrics and Gynecology
