| 范良华.血清IGF-1,IGFBP-3水平在评估生长激素治疗小于胎龄矮小患儿疗效中的应用价值[J].浙江中西医结合杂志,2016,26(6): |
| 血清IGF-1,IGFBP-3水平在评估生长激素治疗小于胎龄矮小患儿疗效中的应用价值 |
| The clinical application value of serum level of insulin-like growth factor and IGF-binding protein-3 in growth hormone treated short children with small for gestational age . |
| 投稿时间：2015-06-04 修订日期：2015-08-24 |
| DOI： |
| 中文关键词: gh |
| 英文关键词: |
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| 中文摘要: |
| 【】 目的 探讨生长激素(GH)治疗小于胎龄(SGA)矮小患儿的疗效以及治疗前血清胰岛素样生长因子-1(IGF-1)、胰岛素样生长因子结合蛋-3(IGFBP-3)水平在临床疗效评估中的应用价值。方法 收集2009月9月-2013年9月期间在我院儿科就诊的SGA矮小患儿共62例,对矮小患儿进行胰岛素、精氨酸两种药物激发试验,采用重组人生长激素进行治疗(0.15U/kg/d)不少于12个月。比较治疗前后平均身高、平均身高SDS以及生长速率的变化情况；比较治疗前血清IGF-1、IGFBP-3水平与治疗后生长速率的相关关系；比较生长激素缺乏(GHD)组和非GHD组治疗疗效的差别。结果 GH治疗前平均身高112.3±17.97 cm,平均身高SDS -3.19±1.26 SDS,生长速率3.64±0.77 cm/y,GH治疗后平均身高123.7±19.37 cm(P<0.01),平均身高SDS-1.88±1.33 SDS(P<0.01),生长速率9.37±1.74 cm/y (P<0.01),均较治疗前有明显改善。GH治疗前血清IGF-1、IGFBP-3与治疗后生长速率均存在显著的负相关关系,r分别为-0.47,-0.42(P<0.01)。GH治疗后,GHD组平均身高增加11.24±3.47 cm,平均身高SDS变化0.97±0.43 SDS,生长速率提高5.37±0.69 cm/y；非GHD组平均身高增加10.93±3.22 cm,平均身高SDS变化1.01±0.27 SDS,生长速率提高5.44±0.87 cm/y,两组差别均无统计学意义(P>0.05)。结论 GH治疗可有效改善SGA矮小患儿身高,长期坚持治疗效果更显著；GH治疗前血清IGF-1、IGFBP-3水平可作为GH治疗的疗效评估指标；且GH治疗效果不受自身GH水平的影响。 |
| 英文摘要: |
| 【】 Objective To evaluate the clinical application value of serum level of insulin-like growth factor (IGF) and IGF-binding protein-3 (IGFBP-3) in growth hormone (GH) treated short children with small for gestational age (SGA). Methods 62 short children with small for gestational age in our hospital from Sep 2009-Sep 2013 were collected to this study. Before GH treatment, insulin and Arginine stimulation test were performed. The children were treated with recombinant GH with 0.15U/kg/d for at least 12 months. The height, height SDS and growth velocity before and after GH treatment were compared. The relevance of pre-treatment serum level of IGF-1 and IGFBP-3 and post treatment growth velocity was analyzed. The growth response of GH deficiency (GHD) and non-GHD group were compared. Results After GH treatment, the height was 123.7±19.37 cm (P<0.01, vs. 112.3±17.97 cm), height SDS was -1.88±1.33SDS (P<0.01, vs. 13.19±1.26 SDS) and growth velocity was 9.37±1.74 cm/y (P<0.01, vs. 3.64±0.77 cm/y), significant higher than before GH treatment. Pre-treatment serum level of IGF-1 and IGFBP-3 were significantly negative relevance with post treatment growth velocity, r=-0.47 and -0.42 (P<0.01), respectively. After GH treatment, height increase, height SDS increase and growth velocity elevation in GHD group were 11.24±3.47 cm, 0.97±0.43 SDS and 5.37±0.69 cm/y, respectively; while height increase, height SDS increase and growth velocity elevation in non-GHD group were 10.93±3.22 cm, 1.01±0.27 SDS and 5.44±0.87 cm/y, respectively, there were no significant differences between GHD group and non-GHD group (P>0.05). Conclusions GH treatment could effectively improve the height of short children with SGA, and long-term treatment is more pronounced. The serum level of IGF-1 and IGFBP-3 before GH treatment could be served as the efficacy of GH therapy evaluation indicators, and the effect of GH treatment could not affected by self-GH level. |
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