班正贺 黎丽嫦 翁碧艳

[摘要] 目的 探讨胎儿生长受限（FGR）孕妇抗心磷脂抗体（ACA）与胎盘组织胰岛素样生长因子- I（IGF-I）表达水平间的关系及两者在FGR发生中的作用。 方法 采用酶联免疫吸附法（ELISA法）测定63例正常足月妊娠孕妇（对照组）及63例胎儿生长受限孕妇(研究组)血清中ACA-IgG、IgM；利用免疫组织化学方法及多媒体彩色病理图像分析技术测定胎盘组织IGF-I表达水平。 结果 研究组抗心磷脂抗体阳性率为19.0%，对照组为3.2%，两组比较，有显著性差异（P＜0.05）; 研究组胎盘组织IGF - 1表达水平明显低于对照组（P＜0.05） ；ACA阳性组与ACA阴性组两组比较，胎盘组织IGF-I表达水平无显著差异（P＞0.05），胎盘重量、胎儿体重有显著差异（P＜0.05）。 结论 孕妇血清ACA阳性或胎盘组织IGF-I表达水平下降是导致FGR的危险因素之一，ACA是否也会导致胎盘组织IGF-I表达水平下降有待进一步研究。

[关键词]胎儿生长受限；胰岛素样生长因子Ⅰ；抗心磷脂抗体

[中图分类号] R714.5   [文献标识码] A   [文章编号] 2095-0616（2014）08-13-03

Correlation study of pregnant women's antiphospholipid antibody and insulin-like growth factor I and fetal growth restriction

BAN Zhenghe1  LI Lichang1  WENG Biyan2

1.Guangzhou Baiyun District First People's Hospital,Guangzhou 510410,China;2.Guangzhou Baiyun District Red Cross Hospital,Guangzhou 510545,China

[Abstract] Objective To investigate the relationship between the pregnant women's expression levels of anti-cardiolipin antibody (ACA) and placental tissue insulin-like growth factor-1 (IGF-I)and their role in fetal growth restriction (FGR). Methods The enzyme-linked immunosorbent assay (ELISA) was used to detect the serum ACA-IgG and IgM of 63 pregnant women with normal full-term pregnancy (control group)and 63 patients with fetal growth restriction(study group);The immunohistochemical method and multimedia color pathological image analysis technique were used to measure the IGF-I expression level in placenta tissues. Results The positive rate of ACA in the study group was 19.0% and that in the control group was 3.2%,with significant difference between the two groups(P＜0.05);The study group was significantly lower than the control group in the IGF-I expression level in placenta tissues(P＜0.05); The ACA positive group and the ACA negative group were not significantly different in the IGF-I expression level in placenta tissues(P＞0.05),but were significantly different in placenta weight and fetal body weight (P＜0.05). ConclusionPositive serum ACA or decreased IGF-I expression levels in placenta tissues of the pregnant women is one of the risk factors of FGR.Whether ACA can decrease the IGF-I expression level in placenta tissues needs further study.

[Key words] Fetal growth restriction;Insulin-like growth factor I;Anti-cardiolipin antibody

胎兒生长受限（fetal growth restriction，FGR）是围生期的重要并发症之一，是造成围产儿发病率和死亡率增高的重要原因之一。FGR迄今病因尚未完全阐明，其中血液高凝状态和母婴某种生长因子或某种酶的缺乏或丢失等因素已被认为是导致FGR的高危因素。类胰岛素因子-I（insulin-like

growth factor-I，IGF-I）是一种多功能的细胞调节因子，可通过多种途径影响胎儿生长发育。抗心磷脂抗体（anticardiolipin antibody，ACA）是一种新型的自身免疫性抗体，影响胎盘结构及破坏其功能，导致母胎物质交换障碍和胎儿的慢性缺氧，造成FGR等不良妊娠的发生。本研究主要通过测定孕妇血清ACA和胎盘组织IGF-I表达水平，探讨其与FGR发生的相关性，现报道如下。……