应用CPVS术治疗的痉挛型脑瘫患儿血清IGF-1水平的变化及其与体格发育指标的关系研究  

Study on changes of serum IGF-1 levels and their relationship with physical development indicators in children with spastic cerebral palsy treated with CPVS surgery

作　　者：高超 艾克拜尔·哈里克[2] 曹胜操 麦哈木提·库尔班 栾新平[2] GAO Chao;Aikebaier Halike;CAO Shengcao(Department of Neurosurgery,Xiamen Hospital of Fudan University Cancer Hospital,Xiamen 361100,China)

机构地区：[1]复旦大学附属肿瘤医院厦门医院神经外科,厦门361100 [2]新疆医科大学第二附属医院神经外科

出　　处：《临床神经外科杂志》2023年第3期323-326,331,共5页Journal of Clinical Neurosurgery

基　　金：国家自然科学基金资助项目(81660202)。

摘　　要：目的研究颈总动脉外膜交感神经网剥脱手术(CPVS)对脑性瘫痪(CP)患儿胰岛素样生长因子-1(IGF-1)以及运动功能的影响,探讨CPVS术前术后脑瘫患儿血清IGF-1水平与患儿年龄、身高、体质量等体格发育指标的关系。方法回顾性分析2019年8月—2020年11月新疆医科大学第二附属医院脑瘫中心收治的77例行单侧CPVS手术的痉挛型脑瘫患儿,对比患儿的术前术后肢体运动水平的改变及血清中IGF-1水平的影响,分析术前术后患儿血清IGF-1水平与年龄、身高、体质量等体格发育指标的相关性。将数据进行统计分析,以P<0.05认为有统计学意义。结果分别统计各年龄层患儿身高、体质量均值,发现其均值均低于标准值,各年龄段患儿术前IGF-1水平均值均低于正常儿童IGF-1参考值下限,行CPVS后各年龄段患儿IGF-1水平均值有所提升,均高于正常儿童IGF-1参考值下限,但低于正常儿童IGF-1参考中位数值(P<0.05),且患儿年龄、身高、体质量与术前IGF-1水平和术后IGF-1水平呈明显正相关,且存在统计学意义(P<0.05)。使用GMFM-88评分评估患儿手术前后肢体功能改善情况,术前评分均值为(72.19±10.60),术后提升至(81.22±9.55),差异有统计学意义(t=-16.727,P<0.05)。结论CPVS能够缓解脑瘫患儿肢体功能,并升高IGF-1水平,且患儿年龄、身高、体质量与术前和术后IGF-1水平呈明显正相关。Objective To investigate the effects of cervical perivascular sympathectomy(CPVS)on insulin-like growth factor-1(IGF-1)and motor function in children with cerebral palsy(CP),and to explore the relationship between serum IGF-1 levels and physical development indicators such as age,height,and weight in children with CP before and after CPVS.Methods 77 children with spastic CP who underwent unilateral CPVS surgery at the CP Center,the Second Affiliated Hospital of Xinjiang Medical University from August 2019 to November 2020 were analyzed retrospectively.The changes in limb movement levels and the impact of serum IGF-1 levels were compared before and after surgery.The correlation between serum IGF-1 levels and physical development indicators such as age,height,and weight were analyzed.The data was statistically conducted.P<0.05 was considered statistically significant.Results The average height and weight of children in each age group were calculated separately,and it was found that their average values were lower than the standard values.The average preoperative IGF-1 levels of children in each age group were lower than the lower limit of the reference value for IGF-1 in normal children.After CPVS,the average IGF-1 levels of children in each age group increased,all higher than the lower limit of the reference value for IGF-1 in normal children,but lower than the median reference value for IGF-1 in normal children(P<0.05),and the age,height There was a significant positive correlation between body weight and preoperative and postoperative IGF-1 levels,with statistical significance(P<0.05).The GMFM-88 score was used to evaluate the improvement of limb function in children before and after surgery.The average preoperative score was(72.19±10.60),and it increased to(81.22±9.55)after surgery,with a statistically significant difference(t=-16.727,P<0.05).Conclusions CPVS can alleviate limb function and increase IGF-1 levels in children with CP.The age,height,and weight of the children are significantly positively correla

关 键 词：小儿脑瘫 颈总动脉外膜交感神经网剥脱术 胰岛素样生长因子-1 运动功能 

分 类 号：R742.3[医药卫生—神经病学与精神病学]