重组人生长激素治疗前后血胰岛素样生长因子-Ⅰ、胰岛素样生长因子结合蛋白水平监测及意义

Research on Correlation between Selenium Level and Cognitive Function for Rural Elderly Population in China

目的通过对使用重组人生长激素(rhGH)患儿进行胰岛素样生长因子-Ⅰ(IGF-Ⅰ)、胰岛素样生长因子结合蛋白(IGFBP3)的监测,探讨rhGH使用的安全性。方法对在本院使用rhGH的患儿30例进行治疗前后血IGF-Ⅰ和IGFBP3浓度监测并计算IGF-Ⅰ和IGFBP3的比值,同时测定T3、T4、TSH,并以年龄、性别匹配20例儿童作为对照组。结果治疗后平均身高增加(8.77±3.01)cm/y(t=7.773,P<0.001)。IGF-Ⅰ治疗前与对照组差异无显著性(t=-0.475,P>0.05),IGFBP3治疗前组高于对照组,差异有显著性(t=3.759,P<0.01),IGF-Ⅰ和IGFBP3治疗后3个月即明显增高,与治疗前相比差异有显著性(t=4.212和7.733,P<0.01)。治疗后IGF-Ⅰ各组之间差异无显著性(f=1.629,P>0.05);IGFBP3各组之间差异有显著性,(f=22.964,P<0.001)与治疗时间呈正相关。IGF-Ⅰ/IGFBP3治疗前后各组之间差异无显著性(f=6.081,P>0.05)。结论在使用rhGH中进行IGF-Ⅰ和IGFBP3监测十分必要;血IGF-Ⅰ和IGFBP3检测方便,可作为rhGH治疗期间是否存在诱发肿瘤高危因素的临床评价指标之一。

Objective To evaluate the safeness of this treatment by comparing the serum IGF - I and IGFBP3 concentration level before and after receiving rhGH treatment in pediatric patients. Methods 30 pediatric patients in our hospital receiving rhGH treatment were subjected to monitor serum IGF -I and IGFBP3 level before and after the treatment and calculate the IGF-I and [GFBP3 ratio. At the same time the serum T3 , T4 and TSH are also assayed. Results The average increase of booly heights was （8.77±3.01） cm/y （t=7.773, P 〈0.001） after the treatment. There was no statistical significance of the serum IGF - I level between the normal control and study group before and after the treatment （ t = - 0. 475, P 〉 0.05 ） , but the serum IGFBP3 （ t = 3. 759, P 〈 0. 01 ） , and was a little high- er of the treatment group than that of the normal control. After three months of treatment, there were significant increase of the serum IGF-I and IGFBP3 level between the study group and normal control （t=4.212, P〈0.01）. After treatment, in the study group, there was no statistical significance of the serum IGF-I between subgroups （f = 1. 629, P 〉0.05）. However, there was statistical significance of the serum IGFBP3 level between subgroups （f= 22.964 P〈0.001 ）. Furthermore, there was positive co-relationship between the duration of the treatment and serum IGFBP3 level. There was no statistical significance of IGF -I/IGFBP3 ratio between the subgroups （f= 6. 081, P 〉 0.05）. Conclusion The serum IGF-I and IGFBP3 level are able to be used as one of clinical evaluation benchmarks to detect the risks of inducing tumor during the rhGH treatment in the pediatric patients.