特发性矮小患儿生长激素变化的研究

Studies on the change of growth hormone in children with idiopathic short stature

目的探讨长春地区特发性矮小(ISS)患儿血中生长激素(GH)的变化及其与胰岛素样生长因子-1(IGF-1)和结合蛋白-3(IGFBP-3)的关系。方法病例组为2009年-2012年长春市儿童医院内分泌科门诊确诊的ISS患儿201例,对照组为同期来院健康体检的儿童50例。所有研究对象均进行体格检查,骨龄测定和问卷调查,生长激素、IGF-1和IGFBP-3检测。结果 ISS患病率为48.09%;ISS患儿城乡比例为1.1∶1;骨龄延迟与HtSDS呈正相关;与正常对照组相比,ISS患儿GH基础值明显增高;ISS患儿GH基础值与IGF-1、IGFBP-3呈正相关;ISS患儿GH峰值与IGF-1水平无关;与IGFBP-3呈明显正相关。结论 ISS患儿可能存在GH受体不敏感导致GH水平升高;IGF-1、IGFBP-3高低可以反映机体GH水平,ISS患儿IGF-1、IGFBP-3降低可能是其发病的原因之一。

Objective To investigate the levels of growth hormone（GH） of children with idiopathic short stature in Changehun and the relationshil3 among its change,insulin like growth factor-1 （IGF-1） and -3 binding protein （IGFBP- 3）. Methods There were 201 cases of idiopathic short stature investigated from the pediatrics endocrine out-pateint de- partment and 50 eases o{ healthy children collected from health physical examination of children＇s hospital of changchun during 2009 and 2012. All subjects were conducted the physical examination, determination of skeletal age, question- naire,detection of growth hormone,IGF-1 and IGFBP-3. Results The prevalence of ISS was 48.09% （201/418）. The urban-rural ratio of ISS children was 1.1 t. Bone age delay and HtSDS were positively correlated. Compared with nor- mal control group,ISS children with basic value o{ GH increased significantly. The basic value of GH in ISS children were positively correlated with IGF-1 and IGFBP-3. The peak value o{ GH in ISS children had nothing to do with the level of IGF-1 and were positively correlated with IGFBP-3. Conclusion The ISS children may be insensitive to GH re- ceptor which lead to elevated the level of GH. The level of IGF-1 and IGFBP-3 may reflect the level of GH,the redu of IGF-1 and IGFBP-3 in ISS children may be one reason for incidence.