母血和脐血瘦素、IGF-1及血脂水平与胎儿生长发育的关系

发布时间：2018-08-20 18:27

【摘要】：目的通过检测孕妇静脉血和新生儿脐静脉血中瘦素（leptin，LP）、胰岛素样生长因子-I（insulin-like growth factor1，IGF-1）和血脂水平，测量新生儿出生体重、身长、头围、胸围和腹围，探讨瘦素、胰岛素样生长因子-I、血脂水平与胎儿生长发育的关系；分析母血瘦素和脐血瘦素、母血胰岛素样生长因子-I和脐血胰岛素样生长因子-I、母血血脂和脐血血脂的相关性。方法选取2011年11月至2012年03月，在河北联合大学附属医院产科住院分娩的无妊娠合并症及并发症的孕妇共90例，新生儿90例。抽取孕妇临产前肘静脉血及胎儿娩出后、胎盘娩出前的脐静脉血，分离血清。采用放射免疫分析法（Radioimmunoassay，RIA）测定母血和脐血中的瘦素及胰岛素样生长因子-I水平，全自动生化分析仪测定母血和脐血中的甘油三酯、胆固醇、低密度脂蛋白、高密度脂蛋白水平。用电子称测量新生儿出生体重，皮尺测量身长、头围、胸围、腹围。SPSS13.0软件进行统计学分析。结果1研究对象一般情况：所选孕妇90例，平均年龄26.55±3.42岁，平均孕期体重增长18.49±4.64kg，平均孕前体重指数（Body mass index，BMI）20.94±2.95。新生儿90例，平均胎龄39.70±1.10周，平均出生体重3418.60±469.36g，平均身长50.04±1.45cm，平均头围33.78±1.33cm，平均胸围34.53±1.55cm，平均腹围34.27±1.42cm。新生儿中，男58例，女32例；经剖宫产50例，经阴道分娩40例。2本研究发现新生儿出生体重、身长、头围、胸围、腹围与母血瘦素水平、脐血瘦素水平呈显著正相关性（P0.05）。3本研究发现新生儿出生体重、身长、头围、胸围、腹围与母血胰岛素样生长因子-I水平和脐血胰岛素样生长因子-I水平呈显著正相关性（P0.05）。4新生儿出生体重、身长、头围、胸围、腹围与母血胆固醇（Cholesterol，CHOL）水平无相关性（P0.05）。本研究尚未发现新生儿出生体重、身长、头围、胸围、腹围与母血甘油三脂、母血低密度脂蛋白（Low-density lipoprotein， LDLC）、母血高密度脂蛋白（High-densitylipoprotein，HDLC）水平有相关性（P0.05）；尚未发现新生儿出生体重、身长、头围、胸围、腹围与脐血甘油三酯、脐血胆固醇、脐血低密度脂蛋白及脐血高密度脂蛋白水平有相关性（P0.05）。5经多元回归分析可知，新生儿体格测量指标均与母血、脐血瘦素水平具有显著相关性（P0.05）。6母血瘦素、IGF-1水平显著高于脐血，差异有统计学意义（P0.05）；母血甘油三酯、胆固醇、显著高于脐血水平，差异有统计学意义（P0.05）。7本研究发现母血瘦素、IGF-1及胆固醇水平与脐血瘦素、IGF-1及胆固醇水平有相关性（P0.05）。尚未发现母血甘油三酯水平与脐血甘油三酯、脐血低密度脂蛋白及脐血高密度脂蛋白水平有相关性（P0.05），，尚未发现母血胆固醇水平与脐血甘油三酯、脐血低密度脂蛋白及脐血高密度脂蛋白水平有相关性（P0.05），尚未发现母血低密度脂蛋白水平与脐血甘油三酯、脐血胆固醇、脐血低密度脂蛋白及脐血高密度脂蛋白水平有相关性（P0.05），尚未发现母血高密度脂蛋白水平与脐血甘油三酯、脐血胆固醇、脐血低密度脂蛋白及脐血高密度脂蛋白水平有相关性（P0.05）。结论1母血、脐血瘦素水平在胎儿生长发育过程当中起重要的调节作用，经多元回归分析，其作用最显著；2母血、脐血胰岛素样生长因子-I和母血胆固醇在胎儿生长发育过程中起重要的调节作用；3母血的甘油三酯、低密度脂蛋白及高密度脂蛋白与脐血甘油三脂、低密度脂蛋白、高密度脂蛋白无相关性，母血的甘油三酯、低密度脂蛋白及高密度脂蛋白与脐血的来源不同，具有各自独立的产生和调节系统。
[Abstract]:Objective To investigate the relationship between leptin, insulin-like growth factor-1 (IGF-1), serum lipid and fetal growth and development by measuring the levels of leptin, insulin-like growth factor-1 (IGF-1) and serum lipid in maternal venous blood and umbilical vein blood. To analyze the correlation between maternal leptin and umbilical cord blood leptin, maternal insulin-like growth factor-I and umbilical cord blood insulin-like growth factor-I, maternal blood lipid and umbilical cord blood lipid.
Methods From November 2011 to March 2012, 90 pregnant women and 90 newborns without pregnancy complications and complications delivered in the obstetrics department of the Affiliated Hospital of Hebei United University were selected. The levels of leptin and insulin-like growth factor-I in maternal and umbilical blood were measured by IA, and the levels of triglyceride, cholesterol, low density lipoprotein and high density lipoprotein in maternal and umbilical blood were measured by automatic biochemical analyzer. Analysis.
RESULTS 1. The average age of 90 pregnant women was 26.55 (+ 3.42) years. The average weight gain during pregnancy was 18.49 (+ 4.64 kg) and the average body mass index (BMI) was 20.94 (+ 2.95). 3 cm, mean chest circumference 34.53 + 1.55 cm, mean abdominal circumference 34.27 + 1.42 cm. Among the newborns, 58 were males and 32 were females; 50 were delivered by cesarean section and 40 were delivered by vagina. (P 0.05). 4 There was no correlation between birth weight, body length, head circumference, chest circumference, abdominal circumference and maternal serum cholesterol (P 0.05). Long, head circumference, chest circumference, abdominal circumference and maternal triglyceride, maternal low-density lipoprotein (LDLC), maternal high-density lipoprotein (HDLC) levels were correlated (P There was a correlation between the levels of lipoprotein and cord blood high-density lipoprotein (P 0.05). 5 By multiple regression analysis, neonatal physical measurement indicators and maternal blood, umbilical blood leptin levels were significantly correlated (P 0.05). 6 maternal blood leptin, IGF-1 levels were significantly higher than umbilical blood, the difference was statistically significant (P 0.05); maternal blood triglyceride, cholesterol, significantly higher than that of maternal blood. This study found that maternal leptin, IGF-1 and cholesterol levels were correlated with cord blood leptin, IGF-1 and cholesterol levels (P 0.05). It was found that maternal blood cholesterol levels were correlated with cord blood triglyceride, cord blood low density lipoprotein and cord blood high density lipoprotein levels (P 0.05). No correlation was found between maternal blood low density lipoprotein levels and cord blood triglyceride, cord blood cholesterol, cord blood low density lipoprotein and cord blood high density lipoprotein levels (P 0.05). The levels of HDL were correlated with triglyceride, cholesterol, LDL and HDL in cord blood (P 0.05).
Conclusion The level of leptin in maternal and umbilical blood plays an important role in the process of fetal growth and development, which is most significant by multiple regression analysis; 2 maternal blood, insulin-like growth factor-I and maternal blood cholesterol play an important role in the process of fetal growth and development; 3 maternal blood triglyceride, low density lipoprotein and high density lipoprotein There was no correlation between LDL and triglyceride, LDL and HDL in cord blood. The maternal triglyceride, LDL and HDL were different from cord blood and had their own independent production and regulation system.
【学位授予单位】：河北联合大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.7

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