摘要：目的:检测胰岛素、血糖在正常妊娠和胎儿宫内生长迟缓(IUGR)的母血和脐动静脉血中的变化。方法:正常妊娠要求终止妊娠采用引产和自然分娩者107例，足月妊娠合并IUGR者32例。采用放射免疫法测定胰岛素值，血糖测定采用葡萄糖氧化酶法。结果:母血中胰岛素值在28周无明显变化，28周时达高峰，之后随孕周的增加而减少，至妊娠末期又达一较高水平；脐动脉血中胰岛素水平逐渐增高，至36周达峰值，以后降而复升；脐静脉血中胰岛素水平无规律性变化。血糖值无明显变化。IUGR母血中胰岛素和血糖与正常晚期妊娠组比较无明显变化，而脐动静脉血中胰岛素及血糖值有明显差异(P<0.01)。结论:IUGR时脐动静脉血胰岛素和血糖值降低，说明胰岛素和血糖在调节胎儿生长、发育方面起重要作用。

    关键词：胰岛素；血糖；脐动脉血；脐静脉血；宫内生长迟缓

    Clinical Research of the Change of Insulin and Glucose Levels Between Normal Pregnancy and Intrauterine Growth Retardation

    YAN Zhao-hua

    (Department of Obstetrics and Gynecology, The Affiliated Hospital to Guangdong Medical College, Guangdong Zhanjiang 524001, China)

    Abstract：Objective: To determine the levels of insulin and glucose in maternal serum(MS), umbilical artery serum(UAS) and umbilical venous serum(UVS) in women with normal-term pregnancy and intrauterine growth retardation(IUGR). Method： 107 cases with normal gestational weeks (induction of labors or spontaneous deliveries) and 32 cases complicated with IUGR were studied. Levels of insulin were measured with sensitive radio immunoassay and that of glucose were measured by the glucose oxidase-peroxidase method. Result： Level of insulin of maternal serum was not significantly different before 28 gestational weeks, and peaked on 28th gestational week, then it decreased with gestational weeks and peaked again at last term. Insulin level in UAS increased gradually to its peak value at 36th gestational week and then decreased and increased again, while that in UVS demonstrated no regular changes. Levels of glucose in MS, UAS, UVS were not significantly different. Level of insulin and glucose of MS in IUGR had no significant change, but they were significantly different in IUGR of UAS and UVS(P<0.01). Conclusion： A decrease of insulin and glucose in UAS and UVS of IUGR was found, which suggested that insulin and glucose played an important role in the growth and development of fetus. ......