血清胰岛素样生长因子-1生成试验在矮小症儿童诊断中的价值初探  

The Preliminary Value of Insulin-Like Growth Factor-1 Generation Test in Diagnosis of Children with Short Stature

作　　者：高兰英[1] 于宝生[1] 王安茹[1] 单晔[1] 

机构地区：[1]南京医科大学第二附属医院,江苏南京210003

出　　处：《儿科药学杂志》2012年第12期13-15,共3页Journal of Pediatric Pharmacy

摘　　要：目的:初步探讨胰岛素样生长因子-l(IGF-1)生成试验在矮小症儿童诊断中的价值。方法:对35例青春发育期前矮小症儿童进行左旋多巴和精氨酸激发试验,根据GH峰值诊断为生长激素缺乏(GHD组,14例)、特发性矮小(ISS组,21例),对所有矮小症儿童予国产重组人生长激素(rhGH)0.3 IU/(kg.d)睡前皮下注射,连续4 d,在试验前及试验结束后次日晨留取标本,采用CLIA法测定血清IGF-1水平。结果:GHD组与ISS组临床资料在身高、骨龄、身高落后方面比较差异无统计学意义,GHD组与ISS组血清IGF-1基础水平分别为(172.61±65.38)ng/mL和(241.90±56.33)ng/mL,GHD组IGF-1基础水平低于ISS组,两组比较差异有统计学意义(P<0.05)。生成试验后GHD组与ISS组IGF-1反应值(△IGF-1)、反应值百分数(△%IGF-1)分别为(195.8±157.90)ng/mL、(133.8±135.13)%和(115.57±74.40)ng/mL、(52.74±40.02)%,GHD组△IGF-1、△%IGF-1高于ISS组,差异均有统计学意义(P<0.05)。结论:IGF-1生成试验可为GHD诊断提供进一步参考,ISS儿童存在GH-IGF-1轴功能异常,IGF-1生成试验在预测rhGH促生长疗效中可能具有一定的价值。Objective： To explore the value of insulin-like growth factor-1 generation test in diagnosis of children with short stature.Methods： Serum GH levels of 35 pre-pubertal children with short stature were determined with levodopa and aginine provocative tests.According to the peak value of serum GH,they were classified into two groups,the GH deficiency group（GHD,n=14） and the idiopathic short-stature group（ISS,n=21）.All children received subcutaneous injection of rhGH 0.3 IU/（kg·d） for 4 days before retiring and serum IGF-1 levels were measured by CLIA before and after the test.Results： There was no significant difference between GHD and ISS group with height and bone age.The basal IGF-1 of GHD and ISS group was（172.61±65.38） ng/mL and（241.90±56.33）ng/mL respectively.There was a significant difference between the two groups in the levels of basal IGF-1.The levels of △IGF-1 and △%IGF-1 in GHD and ISS group were（195.8±157.90）ng/mL,（133.8±135.13）% and（115.57±74.40）ng/mL,（52.74±40.02）%.There were significant differences between the two groups in the levels of △IGF-1 and △%IGF-1（P〈0.05）.Conclusions： There is a further reference in diagnosis of GHD with IGF-1 generation test.ISS patients may have dysfunction of GH/IGF-1 axis.IGF generation test may be valuable in prediction of growth promoting effect in short stature with rhGH treatment.

关 键 词：胰岛素样生长因子-1 矮小症 生成试验 

分 类 号：R725.8[医药卫生—儿科]