IGF-1与IGFBP-3在未青春发育特发性矮小儿童生长激素治疗中的意义

The significance of IGF-1 and IGFBP-3 in growth hormonetherapy of idiopathic short stature in prepuberty

目的探讨血清胰岛素样生长因子-1(IGF-1)和胰岛素样生长因子结合蛋白-3(IGFBP-3)在未青春发育特发性身材矮小(ISS)患儿重组人生长激素(rhGH)治疗过程中的变化及意义。方法观察组50例ISS患儿行国产rhGH治疗,采用酶联免疫分析技术测定其治疗前及治疗7 d、1个月及6个月时的血清IGF-1和IGFBP-3水平。对照组为20例正常儿童。结果观察组治疗前血清IGF-1、IGFBP-3水平均低于对照组(P<0.01或P<0.05);观察组治疗7 d时血清IGF-1、IGFBP-3水平高于治疗前(P<0.01);治疗1个月时接近高峰。治疗前血清IGF-1水平与治疗6个月后的△GV、△HtSDSCA、△HtSDSBA呈负相关,治疗1个月时的△IGF-1与治疗6个月后的△GV、△HtSDSCA、△HtSDSBA呈正相关。结论血清IGF-1可以作为判断和预测GH对未青春发育ISS儿童疗效的指标。

Objective To observe the change of serum levels of insulin-like growth factor-l（IGF-l） and insulin-like growth factor binding protein-3 （IGFBP-3） during rhGH therapy in children with ISS in prepuberty, and to explore its significance. Methods We used chinese rhGH to treat 50 ISS children （observation group） in prepuberty and measured their serum levels of IGF-1 and IGFBP-3 by enzyme-linked immunosorbent assay before, after 7 days, after 1 month and after 6 months of rhGH therapy. There were 20 normal children in control group. Results In ISS children,the serum levels of IGF-1 and IGFBP-3 before rhGH therapy were lower than those in normal control group （P 〈 0.01）. Those ＂after 7 days of rhGH therapy were higher than those before rhGH therapy （P 〈 0.01）. Those were close to the peak af- ter 1 month of therapy. There was a negative correlation between the serum level of IGF-1 before rhGH therapy and the △GV, △HtSDSCA and △HtSDSBA after 6 months of therapy; There was a positive correlation between the AIGF- 1 after 1 month of therapy and the AGV, △HtSDSCA and AHtSDSBA after 6 months of therapy. Conclusion To ISS children in prepuberty with rhGH therapy, the serum IGF-1 can be the good indicator of assessing and predicting GH efficacy.