先天性心脏病手术后生长激素-胰岛素样生长因子轴的变化

Changes of growth hormone and insulin-like growth factor axis before and after surgery in children with congenital heart disease

目的探讨先天性心脏病患儿手术后生长激素(growth hormone)和胰岛素样生长因子(insulin-like growth factor,IGF)轴的变化及意义。方法先天性心脏病25例,采用放射免疫测定法测定治疗前、手术治疗后3个月、6个月和1年空腹血IGF-1及胰岛素样生长因子结合蛋白-3(insulin-like growth factor binding protein-3,IGFBP-3);对照组为正常儿童20名。结果先天性心脏病患儿手术前血IGF-1和IGFBP-3浓度较正常儿童减低(P<0.01);先天性心脏病手术治疗后患儿的IGF-1和IGFBP-3浓度随着术后时间增加而逐渐提高,至1年时与同龄儿童持平,差异无统计学意义(P>0.05)。结论先天性心脏病患儿存在生长发育迟缓及生长激素-胰岛素样生长因子轴功能的紊乱能通过手术治疗纠正,从而改善先天性心脏病患儿生长发育。

Objectives To explore the changes of growth hormone and insulin-like growth factor （GH- IGF） axis before and after surgery therapy in children with congenital heart disease （CHD）. Methods Twenty five pediatric patients with CHD and twenty normal children were enrolled in the study. All the pediatric patients were accepted operation for CHD. Blood specimens from children with CHD were collected at the following timepoints： before the surgery, in the 3rd month, the 6th month and the 12th month after the surgery. Insulinlike growth factor-1 （IGF-1） and insulin-like growth factor binding protein-3 （IGFBP-3） were measured by immunoradiometric assay. Results The plasma level of IGF-land IGFBP-3 were lower in CHD group （P〈 0.01 ） as compared with the normal control subjects, and elevated gradually after the operation. At 12m after operation, there was no significant difference between CHD group and normal controlled （P 〉0.05）. Conclusions There is of GH-IGF axis function in children with CHD. Surgery therapy for CHD could alleviate this kind of disturbance, and therefore improve the growth and development of these children.