Insulin-like Growth Factor-Ⅰ,Ⅱ And Insulin-like Growth Factor Binding Protein-3 In The Role Of Fetal Growth Restriction And Their Changes By The Amnioinfusion Therapy

Objective:1,To explore the relationship between insulin-like growth factor-Ⅰ(IGF-Ⅰ),insulin-like growth factor-Ⅱ(IGF-Ⅱ),insulin-like growth factor binding protein-3 and fetal growth restriction.To provide the new ideas and experimental basis for the clinical diagnosis and treatment.2,By copmparing the changes of IGF-Ⅰ,IGF-Ⅱ,IGFBP-3 levels in maternal serum,ammiotic fluid and infant umbilical cord after amnioinfusion and intravenous infusion to the fetal growth restricton respectively to further velucidate the relationship between the insulin-like growth factor system and fetal growth restriction.To provide the theoretical basis for the feasibility and science of the amnioinfusion to the fetal growth restriction.Materials and methods1,SamplesChoose the 60 medium-term pregnant women with FGR by clinical diagnosis in the Affilicated Guangzhou First People's Hospital of Guangzhou Medical College Obstetric from June 2007～December 2010 as experimental group,24～32 weeks of pregnancy, aged 20～39 years.FGR group was randomly devided into intaminiotic infusion group(FGR1 group) and intavwnous infusion group(FGR2 group),each group has 30 women;30 artificial labor synchronization mid-pregant women without complications are choosed as the control group 1 at the same time, 24～32 weeks of pregnancy, aged 19～40 years. select 30 delivery normal women without complications in the Affilicated Guangzhou First People's Hospital of Guangzhou Medical College Obstetric from June 2007～December 2010 as control group 2,37～41 weeks of pregnancy, aged 20～40 years. FGR group of pregnant women at delivery after treatment with 37 to 41 weeks gestation.All the cases selected were without other medical complications and pregnancy complications,their average ages and gestational ages were no difference.2,Methods(1) FGR group of pregnant women and control 1 group women were drawed aminiotic fluid 10 ml by amniocentesis and Venous blood 10 ml.They were used to determine the IGF-Ⅰ, IGF-Ⅱand IGFBP-3 levels.(2) FGR and normal control 2 group women before delivery (natural delivery or caesarean section) were drawed venous blood 10ml, amniotic fluid 10ml. ,collectad the fetal cord blood 10ml after delivery immediately.detetct the level of IGF-Ⅰ,IGF-Ⅱ,IGFBP-3.(3) After delivery,record the neonatal birth height and weight and placental weight of the two FGR groups.3,Detection(1)Determine the concentration of IGF-Ⅰin serum of maternal, newborn cord blood serum and amniotic fluid with radioimmunossay(RIA).(2)Determine the concentration of IGF-Ⅱ,IGFBP-3 in serum of maternal, newborn cord blood serum and amniotic fluid with Enzyme-linked immunosorbent assay(ELISA).4,Statistics analysisData were recorded as (X|-)±s.The results were analyzed by one-factor analysis of variance(ANOVA) with SPSS 15.0 statistical software.Significance was set at P<0.05.Results1,Compared with control group 1,the IGF-Ⅰlevels of two FGR groups in maternal blood, amniotic fluid and umbilical cord were significantly lower, the difference was statistically significant (P <0.05). 2,Compared with control group 1, the IGF-Ⅱlevels of two FGR groups in amniotic fluid and umbilical cord were significantly lower,the difference was statistically significant (P<0.05), while in the maternal was no significantly different, (P>0.05).3,Compared with control group 1,the IGFBP-3 levels of two FGR groups in amniotic fluid and cord blood were significantly increased, the difference was statistically significant (P <0.05), while in the maternal was not significantly different, (P>0.05).4,At delivery,IGF-Ⅰlevels in maternal blood,amniotic fluid and infant cord blood of amnioinfusion treatment group were significantly higher than those of the intravenous treatment group,less than those of the control group 2, the difference was statistically significant (P<0.05).5,At delivery, IGF-Ⅱlevels in amniotic fluid and infant cord blood of amnioinfusion treatment group were significantly higher than those of the intravenous treatment group,less than those of the control group 2, the difference was statistically significant (P <0.05); while the maternal IGF-Ⅱlevel was no significantly different, (P> 0.05).6,At delivery, IGFBP-3 levels in amniotic fluid and infant cord blood of amnioinfusion treatment group were significantly lower than those of the intravenous treatment group,higher than those of the control group 2, the difference was statistically significant (P <0.05); while the maternal IGFBP-3 level was no significantly different, (P> 0.05).7,At delivery,the birth weight,placental weight and the body length of the amnioinfusion treatment group were higher than those of the intravenous treatment group,lower than those of the control group 2,the difference was statistically significant (P <0.05).Conclusions1,Compared with the control group 1 and control group 2 respectively,IGF-Ⅰ,Ⅱlevels in IGF group are decreased both in the second trimester and in delivery,while IGFBP-3 in FGR group are increased—it tell us that the IGF-Ⅰ,Ⅱand IGFBP-3 are perhaps closely related to the occurrence and development of FGR. Combining the current universal detection index (Uterine height and abdominal circumference of pregnant, various diameters of fetal and Umbilical artery blood by B-mode ultrasound, etc.),We can early accurately diagnosis the FGR and monitor intrauterine growth by detecting the IGF-Ⅰ, Ⅱ,IGFBP-3 levels of maternal blood and amniotic fluid . Dynamic testing these levels has significance for the prevention, diagnosis, prognosis and prognostic of FGR.2,Amnioinfusion compared with the maternal intavwnous infusion of amino acids and energy mixture to treat the FGR,the former is a more effective method of the treatment to FGR,and we can evaluate the efficacy of the the therapy by detecting the IGF-Ⅰlevels in maternal and IGF-Ⅰ,Ⅱ,IGFBP-3 levels in amniotic fluid.