胰岛素样生长因子-1在DDH并发股骨头无菌性坏死中意义

Insulin-like growth factor 1 in developmenta l dislocation of hip with avascular necrosis of femur head

目的观察血清胰岛素样生长因子-1(Insulin-likeGrowthFactor-1,IGF-1)在发育性髋关节脱位(developmentaldislocationofhip,DDH)保守治疗中并发股骨头无菌性坏死时的变化和早期诊断意义。方法本组87例DDH患儿,治疗前骨盆片均未见股骨头无菌性坏死,随访6个月,根据随访时骨盆X线片征象,分为DDH并发股骨头无菌性坏死组和DDH骨盆片阴性组;对照组87例,为年龄、性别等条件相匹配的内科患儿,采用酶联免疫吸附法检测血清IGF-1。结果发现DDH并发股骨头无菌性坏死组的IGF-1显著高于DDH骨盆片阴性组和术前组,DDH骨盆片阴性组与术前组及对照组之间的IGF-1差别没有显著意义;有9例DDH患儿,3个月随访时IGF-1异常升高,到6个月时有3例发生股骨头无菌性坏死。结论IGF-1在DDH并发股骨头无菌性坏死时明显增高,在早期诊断中有一定意义。对于IGF-1的异常升高,宜密切随访。

Objective To evaluate the clinical significance of insulin-like growth factor 1 （IGF-1） in developmental dislocation of hip （DDH） with avascular necrosis of femeral head . Methods Eighty - seven patients with I）DH and 87 control subjec＇ts were fc~｜lowed up for six months. The serum IGF-1 concentrations were determined using Enzyme Linked Irnmunosorbent Assay （ELISA）. The IGF-1 concentration was analysed with SPSS software. Results We found that serum IGF-1 concentration in DDH with avascular necrosis of femur head was significantly higher than those of DDH with no avascular necrosis and the controls. The difference between DDH with no avascular necrosis of femur head and the con＇trol was not significant. In addition, three of nine DDH patients with extraordinarily high IGF-1 concentration at three month follow-up developed avascular necrosis of femur head at the six month follow- up. Conclusions Serum IGF-1 concentration is a useful in early diagnose DDH with avascular necrosis of femur head.