血清胰岛素样生长因子-1、胰岛素样生长因子结合蛋白-3在矮小症儿童诊断和疗效判断中的价值  

Values of Insulin-Like Growth Factor 1 and Insulin-Like Growth Factor Binding Protein 3 in Diagnosis and Therapeutic Effect Judging in Children with Short Stature

作　　者：谢理玲[1] 柯江维[1] 杨玉[1] 杨利[1] 李玲芳[1] 周斌[1] 吴限[1] 邹海英[1] 

机构地区：[1]江西省儿童医院内分泌科,南昌330006

出　　处：《实用儿科临床杂志》2008年第20期1604-1606,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨胰岛素样生长因子-1(IGF-1)及其结合蛋白-3(IGFBP-3)在矮小症儿童诊断及疗效判断中的价值。方法1.对124例青春发育前矮小症患儿用精氨酸激发试验和可乐定激发试验检测其血清生长激素(GH)水平,并根据患儿GH峰值分为生长激素缺乏组(GHD组,40例)、特发性矮小组(ISS组,84例)。选取20例健康儿童作为健康对照组。对所有儿童采用酶联免疫吸附法检测血清IGF-1和IGFBP-3。对GHD组、ISS组和健康对照组儿童血清IGF-1和IGFBP-3水平进行两两比较。2.对15例GHD和30例ISS患儿予国产重组人生长激素(rhGH)0.1 IU/(kg.d)治疗6个月,于治疗前及治疗6个月分别测定其身高、体质量、骨龄及血清IGF-1、IGFBP-3,并进行治疗前后的对照。结果1.GHD组和ISS组患儿血清IGF-1和IGFBP-3水平明显低于健康对照组(Pa<0.01),GHD组与ISS组患儿血清IGF-1和IGFBP-3水平比较均有显著差异(Pa<0.01),GHD组患儿治疗前后血清IGF-1、IGFBP-3比较有显著差异(Pa<0.01);诊断GHD,IGF-1的特异性为67.8%,敏感性为75%;IGFBP-3的特异性为88%,敏感性为85%。2.rhGH治疗后身高增长速度明显加快,血清IGF-1、IGFBP-3水平显著升高;治疗前血清IGF-1与治疗6个月生长速度呈显著负相关(r=-0.78 P<0.01);治疗6个月后IGF-1的变化与治疗后生长速度呈显著正相关(r=0.82 P<0.01)。结论IGF-1、IGFBP-3可用于儿童矮小症的诊断及疗效评价。Objective To explore the values of insulin - like growth factor 1 （ IGF - 1 ） and insulin - like growth factor binding protein 3 （ IGFBP - 3 ） in diagnosis and therapeutic effect judging in children with short stature. Methods 1. Serum growth hormone （GH） levels of 124 preadolesent children with short stature were determined with arginine stimulation and clonidine provocation tests, and according to the peak value of serum GH, they were classified into 2 groups：growth hormone deficiency group （GHD group, n = 40） and idiopathic short stature group （ ISS group, n = 84 ）. Twenty healthy children were selected as control group. At the same time, serum IGF - 1 and IGFBP - 3 levels were determined by ELISA for GHD, ISS and control groups, and the serum IGF - 1 and IGFBP -3 levels of GHD group, ISS and control groups were compared by pairwise. 2. In all subjects, 15 children with GHD were treated with domestic recombinant human growth hormone （rhGH） for 6 months, the dosage was 0.1 IU / （ kg · d）. Their height, body weight, bone age, serum IGF - 1 and IGFBP - 3 levels were measured before and after 6 months of the treatment. Results 1. The serum IGF - 1 and IGFBP - 3 levels in GHD and ISS groups were significantly lower than those in control group （ Pa 〈 0.01 ） ; the serum IGF - 1 and IGFBP - 3 levels in GHD and ISS group were significant differences（ Pa 〈 0. 01 ）, the serum IGF - 1 and IGFBP -3 levels of GHD before and after treatment were compared with a significant difference （Pa 〈 0. 01 ） ;diagnosis of GHD ,IGF - 1 for 67.8% of specilicity ,sensitivity for 75% ;the specificity of IGFBP - 3 was 88% ,a sensitivity of 85%, 2. rhGH treatment was markedly aecelerated growth rate, serum IGF- 1, IGFBP- 3 levels increased significantly ;The level of serum IGF - 1 in pretreatment was negatively correlated to the growth velocity （ GV ） after 6 months of treatment （ r = - 0. 78 P 〈 0. 01 ） ;The changes of IGF - 1 after 6 months treatment was significantly positive co

关 键 词：矮小症 胰岛素样生长因子-1 胰岛素样生长因子结合蛋白-3 重组人生长激素 儿童 

分 类 号：R725.8[医药卫生—儿科]