血清IGF-1及生长激素检测水平对内分泌相关疾病的评估价值研究进展

Research progress on the evaluation value of the detection levels of serum IGF-1 and growth hormone for endocrine-related diseases

生长激素(GH)及胰岛素样生长因子1(IGF-1)是人体内重要的内分泌激素,其相关疾病(如肢端肥大症和生长激素缺乏症)可导致继发的心血管疾病、脑血管和呼吸系统疾病的发病率及病死率明显增高。临床上,血清GH、IGF-1的测定与监测是此类疾病诊断、评估疗效以及制定后续治疗方案的重要手段,受到临床医师的广泛关注和重视。虽然大多数情况下血清GH、IGF-1水平是一致的,但越来越多的研究报道血清GH与IGF-1结果可出现不合理甚至矛盾的情况。在血清GH和IGF-1水平不一致的情况下,用于评估疾病状态及控制程度的可靠生化标准目前存在争议,对其进行合理解释也是一个临床难题。本文针对血清GH及IGF-1的检测方法、生理病理状态、药物等对检测结果的影响及其可能机制进行阐述,提出临床上需要仔细梳理可能导致不合理结果的因素,以期更准确地判断检测结果并对相关疾病进行恰当的诊治。

Growth hormone(GH)and insulin-like growth factor 1(IGF-1)are the important endocrine hormones for human,and their associated diseases(e.g.acromegaly and growth hormone deficiency)can lead to obviously increased morbidity and mortality secondary to cardiovascular,cerebrovascular and respiratory diseases.Clinically,the determination and closely monitoring of serum GH and IGF-1 are important means for diagnosing,assessing curative effect and formulating post-treatment follow-up plans of such diseases,and have received extensive concern from clinicians.Although the levels of serum GH and IGF-1 are consistent in most cases,more and more studies have reported that the results of serum GH and IGF-1 are unreasonable or even contradictory.Therefore,in the conditions of inconsistent serum GH and IGF-1 levels,reliable biochemical criteria for assessing disease status and control degree are currently controversial,and their rational interpretation remains a clinical challenge.In present paper,the influence of serum GH and IGF-1 detection methods,physiological and pathological states,and drugs on the detection results and the possible reasons or mechanisms are explained in detail,and proposes that it is necessary to carefully sort out the factors that may lead to unreasonable results in clinic,in order to judge the detection results more accurately and conduct appropriate diagnosis and treatment of the related diseases.