IGF-Ⅰ、IGFBP-3诊断矮小儿童生长激素缺乏的价值

Values of IGF-Ⅰ and IGFBP-3 in Diagnosis of Growth Hormone Deficiency to Children with Short Stature

目的:探讨胰岛素样生长因子-Ⅰ(IGF-Ⅰ)和胰岛素样生长因子结合蛋白-3(IGFBP-3)诊断矮小儿童生长激素缺乏的价值。方法:①对64例身材矮小患儿用精氨酸激发试验和左旋多巴激发试验检测其血清生长激素(GH)水平,两项药物激发试验GH峰值均<10ng/ml诊断为生长激素缺乏(GHD组,40例),其中有一项激发试验GH峰值>10ng/ml,即可确实诊断为特发性矮小症(ISS组,23例)。选取45例健康儿童作为对照组。②用化学发光法检测血清IGF-Ⅰ和IGFBP-3水平。结果:①血清IGF-Ⅰ水平,GHD组为(80.35±32.46)ng/ml,ISS组为(123.26±62.13)ng/ml,正常对照组为(362.20±78.21)ng/ml;血清IGFBP-3水平,GHD组为(2.67±1.32)ng/ml,ISS组为(3.62±1.524)ng/ml,正常对照组(6.39±1.06)ng/ml。②GHD组和ISS组患儿血清IGF-Ⅰ和IGFBP-3水平显著低于健康对照组(P<0.05);GHD组比ISS组患儿血清IGF-Ⅰ、IGFBP-3水平减低有显著性差异(P<0.05)。③按正常对照组x-2s作为临界值诊断GHD,IGF-Ⅰ的阳性率为95%;IGFBP-3的阳性率为92.5%;IGF-Ⅰ、IGFBP-3水平同时评价时,阳性率为87.50%。结论:IGF-Ⅰ、IGFBP-3检测可用于诊断身材矮小儿童的生长激素缺乏。

Objective To explore the values of insulin -like growth factor I （ TGF - I ） and insulin-like growth factor binding protein 3 （IGFBP-3） in diagnosis of growth hormone deficiency to children with short stature. Methods ①Serum growth hormone （GH） level of 64 children with short stature was determined with arginine and levodopa provocation tests, and according to the peak value of serum GH, they were classified into 2 groups： while the two tests peal： value showed 〈 10ng/ml,growth hormone deficiency was diagnosed substantially（GHD group, n =40） ;however one of two tests peak value was 〉 10ng/ml,idiopathic short stature was diag- nosed（ ISS group, n =23）. Forty-five healthy children were selected as control group. ②Serum IGF- I and IGFBP -3 levels were de- termined by hemiluminescence immunoassay（CLIA） for GHD, ISS and control groups. Results ①The serum IGF- I levels showed （80.35 ±32.46） ng/ml, （ 123.26 ±62.13） ng/ml and （362.20±78.21 ） ng/ml in GHD group, ISS group,and control group respec- tively. The serum IGFBP-3 levels were （2.67 ± 1.32） ng/ml, （3.62± 1. 524） ng/ml, and （6.39± 1.06） ng/ml in GHD group, ISS group, and control group individually. ② The serum IGF- I and IGFBP-3 levels in GHD and ISS groups proved significantly lower than those in control group（P 〈0.05） ; the serum IGF- I and IGFBP-3 levels in GHD presented markedly lower than those in ISS group（P 〈 0. 05 ） ; ③On the basis of the control group the mean-2s as the critical value , the positive rates of diagnosing GHD, in IGF- I and IGFBP-3 , was 95% and 92.5% respectively. If IGF- I and IGFBP-3 level were evaluated simultaneously , the positive rates was 87.50%. Conclusion the IGF- I , IGFBP-3 can be used to diagnose growth hormone deficiency in children with short stature.