孙瑞,王鉴
SUN Rui,WANG Jian

• 1:贵州医科大学
• 2:贵州医科大学附院儿科

摘要(Abstract)：

目的:探讨胎龄、出生季节、感染对0~6月婴儿骨生化标志物与胰岛素样生长因子-I(IGF-I)的影响。方法:109例新生儿根据胎龄分早期早产儿组(37例)、晚期早产儿组(41例)及足月儿组(31例),根据出生季节分春季组(25例)、夏季组(28例)、秋季组(29例)及冬季组(27例),早产儿根据是否感染分为感染组(42例)和非感染组(36例);检测各组婴儿出生后1 h、7 d、3月及6月时的血清钙、磷、维生素D3(Vit D3)、骨源性碱性磷酸酶(BAP)及IGF-I。结果:被检婴儿血清Vit D3、钙、IGF-I水平随胎龄增加而升高(P<0.05),Vit D3、钙水平随日龄增加而升高(P<0.05);早产儿血清IGF-I水平随日龄增加而升高(P<0.05),血清BAP、磷水平随着新生儿胎龄、日龄增加而降低(P<0.05);非感染组早产儿血清Vit D3、钙、IGF-I水平较感染组高,BAP、磷水平较感染组低(P<0.05);血清Vit D3、钙及IGF-I水平按秋季、夏季、春季及冬季依次降低(P<0.05),BAP及磷水平依次升高(P<0.05)。结论:胎龄、感染及出生季节对0~6月婴儿不同日龄的骨生化标志物及IGF-I有影响。
Objective: To investigate the effect of gestational age,birth season and infection on biochemical markers of bone and Insulin-like Growth Factor-I( IGF-I) in 0 ~ 6 month newborns. Method: According to different gestational age,109 newborns( born in hospital from Mar. 2014 to Jun.2015) were divided into early-preterm group( n = 37),late-preterm group( n = 41) and full-term group( n = 31). According to birth season,109 newborns were divided into spring group( n = 25),summer group( n = 28),autumn group( n = 29) and winter group( n = 27). According to infected or not,premature infants were divided into infected and non-infected group. Then serum levels of calcium( Ca),phosphorus( P),vitamin D3(Vit D3),bone alkaline phosphatase( BAP) and IGF-I were detected in each group on 1~(st) hour,7~(th) day,3~(rd) month and 6thmonth after born,respectively. Results: The levels of VitD_3,Ca,IGF-I was increased with gestational age in all group,and the difference was statistically significant( P < 0. 05). The levels of VitD_3,Ca increased with age in days in all groups,and the difference was statistically significant( P < 0. 05). The level of IGF-I increased with age in days in early-preterm and late-preterm,and the difference was statistically significant( P < 0. 05); The levels of BAP and P decreased with gestational age and age in days in all groups,and the difference was statistically significant( P < 0. 05). The levels of VitD_3,Ca and IGF-I in non-infected premature infants were significantly higher than their counterparts in infected premature infants while the levels of BAP and P in non-infected premature infants significantly lower than those of infected premature infants( P< 0. 05). The levels of VitD_3,Ca and IGF-I decreased with the order of autumn,summer,spring and winter group,and the difference was statistically significant( P < 0. 05) while the levels of BAP and P increased with the order of autumn,summer,spring and winter group,and the difference was statistically significant( P < 0. 05). Conclusion: Gestational age,infection and birth season may have effects on biochemical markers of bone and IGF-I levels in 0 ~ 6 month newborns.

关键词(KeyWords)： 婴儿,早产;维生素D3;碱性磷酸酶;胰岛素样生长因子-I;钙;磷
infant;premature infant;vitamin D3;bone alkaline phosphatase;insulin-like growth factor-I;calcium;phosphorus

Abstract:

Keywords:

基金项目(Foundation): 贵州省科技厅科学技术基金[黔科合J字(2009)2160号]

作者(Author): 孙瑞,王鉴
SUN Rui,WANG Jian

DOI: 10.19367/j.cnki.1000-2707.2016.06.018

参考文献(References)：

• [1]中华医学会儿科学分会儿童保健学组,全国佝偻病防治科研协作组.维生素D缺乏性佝偻病防治建议[J].中华儿科杂志,2008(3):190-191.
• [2]王丹虹,陈平洋.早产儿代谢性骨病防治进展[J].国际儿科学杂志,2014(5):508-514.
• [3]Colson A,Williems B,Thissen JP.Inhibition of TNF alpha production by pentoxifylline does not prevent endotoxins-induced decrease in serum IGF-1[J].J Endocrinol,2003(1):101-109.
• [4]邵肖梅,叶鸿瑁,丘小汕,等.实用新生儿学[M].4版.北京:人民卫生出版社,2011:340-944.
• [5]胡亚美,江载芳,申昆玲,等.诸福棠实用儿科学[M].8版.北京:人民卫生出版社,2011:564,2884.
• [6]薛辛东,杜立中,毛萌.儿科学[M].北京:人民卫生出版社,2010:87.
• [7]黄华,卢万清,叶远青,等.新编实用临床检验指南[M].2版.北京:人民军医出版社,2013:152.
• [8]Arosio M,Cortelazzi D.Circulating levels of growth hormone,insulin-like facor-I and prolactin in normal,growth retarded an anencephalic human fetus[J].J Endocrinal Invest,2001(5):346-353.
• [9]Akcakus M,koklu E,kurtoglu S,et al.The relationship among intrauterine growth,insulin-like factor-I(IGF-I),IGF-binding protein-3,and bone mineral status in newborn infants[J].Am J Perinatol,2006(8):473-480.
• [10]余暮雪,陈东平,李晓瑜,等.胰岛素样生长因子-I与早产儿早期营养及生长关系的临床研究[J].中国实用儿科杂志,2006(1):87-90.
• [11]陈艳华.早期新生儿血钙、磷、骨碱性磷酸酶水平及临床意义[J].中国误诊学杂志,2009(25):6093-6094.
• [12]Rogers I,Metealfe C,Gunnell D,et al.Insulin-like growth factor-I and growth in height,leg length,and trunk length between ages 5 and 10 years[J].J Clin Endoerinol Metab,2006(7):2514-2519.
• [13]王新利,康新,关于红,等.胰岛素样生长因子-1与健康婴儿生长速度及喂养关系分析[J].中国儿童保健杂志,2011(4):354-357.
• [14]王鉴,杨萌婷,陈晓霞,等.早产儿追赶生长与胰岛素抵抗的相关性[J].中华实用儿科临床杂志,2015(30):593-596.
• [15]Kalliokoski P,Bergqvist Y,Lofvander M.Physical performance and 25-hydroxyvitmain D:a cross-sectional study of pregnant Swedish and Somali immigrant women and new mothers[J].BMC Pregnancy and Childbirth,2013(1):237.
• [16]王文美.孕妇学期维生素D的表达及意义[J].中国实验诊断学,2015(4):605-607.
• [17]谢而付,蒋理,徐建,等.南京地区孕妇冬季与夏季血清25-羟维生素D水平的差异[J].中华围产医学杂志,2013(2):100-101.
• [18]连星烨,孟增东.不同地区光照量与人体维生素D水平及骨密度之间的关系[J].中国骨质疏松杂志,2012(2):183-187.

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