矮小儿童血清生长激素胰岛素样生长因子-1及尿生长激素检测的临床意义  

Clinical value of serum insulin-like growth factor 1,serum growth hormone and urinary growth hormone measurement in short-statured children.

作　　者：严学勤[1] 魏虹[1] 梁雁[1] 侯凌[1] 张建玲[1] 罗小平[1] 

机构地区：[1]华中科技大学同济医院儿科,湖北武汉430030

出　　处：《中国实用儿科杂志》2006年第7期511-512,513,514,共4页Chinese Journal of Practical Pediatrics

基　　金：卫生部临床学科重点建设项目;国家十五攻关重点项目(编号:2004BAT20A01)

摘　　要：目的探讨血清生长激素（GH）、胰岛素样生长因子-1（IGF—1）及尿GH检测对矮小儿童诊断的意义。方法华中科技大学同济医院儿科于2004-11—2005-06对106例矮小儿童进行垂体功能复合刺激试验，试验前收集所有受试者夜间12h（20：00-8：00）尿。另选取19例正常青春发育期前儿童为对照组。对垂体功能复合刺激试验GH分泌异常的56例矮小儿童，用ELISA方法检测相应的血清GH、IGF—1及尿中GH水平，并进行相关分析。结果根据垂体功能复合刺激试验的GH检测结果将矮小儿分类，包括完全性GH缺乏症（cGHD）25例、部分性GH缺乏症（pGHD）9例和GH神经分泌功能障碍（GHND）22例。GHD组患儿血清IGF—1、尿GH水平与正常儿相比明显降低（P〈0．01）。pGHD和GHND组患儿血IGF—1水平波动较大，无统计学差异。GHND组患儿尿GH水平按ng／s肌酐（Cr）计量显著低于正常对照相（P〈0．05），而按ng／12h尿量计算值虽低于正常组，但无统计学意义（P〉0.05）。pGHD组患儿尿GH水平按两种方法计量值均介于正常和GHD患者之间，与正常及GHD患者比较均有显著性差异（P均〈0．05）。cGHD和pGHD组患儿尿GH的ng／sCr计量值与其血GH峰值呈显著性正相关（rcGHD=0.556，P〈0．05；rpGHD=0.423，P〈0，05），GHND组患儿尿GH的ng／g Cr计量值与其血中GH峰值无相关性（P〉0．05）。结论尿GH水平测定无创、简便，配合IGF—1等指标的检测，对于矮小儿童的诊断和鉴别诊断具有重要意义。Objective To investigate the significance of serum growth hormone, serum insulin-like growth factor-1 （ IGF- 1 ） and urinary growth hormone （ GH ） levels in the diagnosis of short statured children. Methods From Nov. 2004 - Jun. 2005 to 106 short statured children and 19 normal children in prepuberty were selected,each having 12h （8 ：00pm- 8： 00AM ） urine collection. The short statured children were given combined pituitary hormone provocating tests,and the corresponding serum GH, IGF-1 and urinary GH were determined by ELISA kits. Results According to the serum GH levels of provocating tests, the short-statured children were divided into three groups： complete growth hormone deficiency （cGHD） 25 cases, partial growth hormone deficiency （pGHD） 9 cases, disorders of growth hormone neurosecretion （GHND） 22 cases. IGF-1 and urinary GH in cGHD groups were remarkably lower than those in normal children（ P 〈 0. 01 ）. IGF-1 value of pGHD and GHND group fluctuated comparatively greatly,so there was no statistical significance compared to normal children. Urinary GH pg/mg creatinine（Cr） count in GHND group had significant difference vs. norreal group（ P 〈0. 05 ） , although urinary GH ng/12h count value was lower than normal group,there is no statistical significance （ P 〉 0. 05 ）. The two kinds of urinary GH in pGHD group were between normal and cGHD, and there was predominant difference vs. normal group （ P mean 〈 0. 05 ）. Urinary GH pg/mg Cr count in cGHD and pGHD groups were positively correlated with the serum GH peak （ rcGHD = 0. 556, P 〈 0. 05 ; rpGHD = 0. 423, P 〈 0. 05 ） , respectively. Conclusion Serum IGF-1 and urinary GH levels have important significance in the diagnosis of short statured children.

关 键 词：胰岛素样生长因子-1 血清生长激素 尿生长激素 矮小儿童 

分 类 号：R72[医药卫生—儿科]