血清IGF_1、IGFBP_3及OST用于判断性早熟儿童骨骼发育异常及疗效  

The significance of measuring serum IGF_1,IGFBP_3 and OST for the judgement of abnormal skeletal development and therapeutic monitoring in precocious children

作　　者：季志英[1] 赵瑞芳[1] 吕孝妹[1] 顾凡磊[1] 蔡德培[1] 

机构地区：[1]复旦大学附属儿科医院核医学科,上海200032

出　　处：《中华核医学杂志》2004年第2期73-76,共4页Chinese Journal of Nuclear Medicine

摘　　要：目的　探讨血清胰岛素样生长因子Ⅰ (IGF1 )、胰岛素样生长因子结合蛋白Ⅲ (IGFBP3)及骨钙素 (OST)在性早熟儿童骨骼发育异常严重程度的判断及疗效考核上的价值。方法　对 117例特发性性早熟女孩 ,采用双抗体夹心免疫放射分析法测定血清IGF1 及IGFBP3含量 ,用放射免疫分析法测定血清OST含量。患儿按年龄分组 ,各项测定值与同龄儿正常值对比 ;再将患儿按青春发育分期 (病情严重程度 )分组 ,各项测定值与青春发育分期水平之间行相关分析。并对骨龄提前程度与血清IGF1 含量间行相关分析。其中 38例患儿于治疗 6个月后重复测定各项指标 ,作治疗前后对比。结果　①性早熟女孩血清IGF1 及OST浓度均较同龄儿明显增高 ,而血清IGFBP3浓度较同龄儿明显降低。②血清IGF1 浓度与青春发育分期水平呈正相关 (r=0 4 89,P <0 0 5 ) ,与骨龄提前程度亦呈正相关 (r=0 4 11,P <0 0 5 )。③治疗后IGF1 浓度从 (4 5 5 5 2± 119 4 5 ) μg L降为 (2 84 5 5± 99 5 2 ) μg L(P <0 0 0 1) ,血清OST浓度从 (2 9 82± 10 6 2 ) μg L降为 (14 0 7± 4 71) μg L(P <0 0 0 1) ,表明随病情缓解 ,血清IGF1 及OST均明显下降。结论　血清IGF1 及OST可作为判断特发性真性性早熟女孩骨骼生长加速、成熟提前严重程度的定量指?Objective To study the value of measuring serum insulin-like growth factor Ⅰ (IGF 1),insulin-like growth factor binding protein Ⅲ (IGFBP 3) and osteocalcin (OST) for evaluating acceleration of skeletal growth and skeletal maturity,and its value for therapeutic monitoring in precocious children. Methods Serum IGF 1 and IGFBP 3 were measured with immunoradiometric assay,serum OST was measured with radioimmunoassay in 117 girls with idiopathic precocious puberty. The girls were grouped according to age,and various parameters collected from them were compared with normal values of matched girls. Furthermore,the girls were grouped according to Tanner's staging (the extent of precocious puberty),the analysis of correlativity between various parameters to the extent of precocious puberty was performed,and the analysis of correlativity between the level of serum IGF 1 and advancing of bone age was performed. Various parameters were measured once more in 38 of the study girls after six months of the treatment,and the parameters were compared with that before treatment. Results ①The levels of serum IGF 1 and OST in the girls with precocious puberty were elevated obviously than that in matched normal girls,but the level of serum IGFBP 3 was reduced obviously than that in matched normal girls. It was demonstrated that typical elevation of serum IGF 1 and OST occurred in normal adolescence appeared ahead of time in the girls with precocious puberty. ②The extent of precocious puberty correlated closely with the level of serum IGF 1 ( r=0.489,P <0.05),and the advancing of bone age correlated closely with the level of serum IGF 1 ( r=0.411,P <0.05). It was demonstrated that the more serious the acceleration of skeletal growth and advancing of skeletal maturity were,the more obvious the elevation of serum IGF 1 was. ③After the treatment,the concentration of serum IGF 1 reduced from (455.52±119.45) μg/L to (284.55±99.52) μg/L ( P <0.001),and the concentration of serum OST reduced from (29.82±10.62) μg/L

关 键 词：血清 IGF1 IGFBP3 OST 早熟儿童 骨骼发育异常 

分 类 号：R725.8[医药卫生—儿科]