重组人生长激素对青春发育后期特发性矮小患儿的促生长效应及血清IGF-1、IGFBP-3的检测意义

目的探讨重组人生长激素（rhGH）对青春发育后期特发性矮小（ISS）患儿的促生长效应及血清胰岛素样生长因子-1（IGF-1）、胰岛素样生长因子结合蛋白-3（IGFBP-3）的检测意义。方法对40例青春发育后期ISS患儿进行rhGH治疗，于治疗前及治疗6个月时测定身高、体质量及骨龄，治疗1及6个月时抽血测定IGF-1和IGFBP-3水平。结果治疗6个月后生长速度（GV）、按年龄的身高标准差积分（HtSDScA）、按骨龄的身高标准差积分（HtSDSBA）及预测终身高（PAH）均较治疗前增高（均P〈0．01）。治疗1及6个月后血清IGF．1水平均较治疗前明显升高（均P〈0．05），治疗前后血清IGFBP．3水平差异无统计学意义（P〉0．05）。治疗前的血清IGF．1与治疗6个月后的AGV呈负相关（r=0．39，P〈0．05），治疗1个月后AIGF-1与治疗6个月时的生长指标△GV、AHtSDSCA及AHtSDSBA均呈正相关6-=0．42、0．38、0．33，P〈0．05）。结论青春发育后期ISS患儿接受rhGH治疗是安全的，疗效是肯定的，血清IGF-1可以作为判断和预测GH对青春发育后期ISS患儿疗效的指标。

Significance of IGF-1 and IGFBP-3 in growth hormone therapy of idiopathic short stature in late puberty

Objective To explore the growth promotion effect of recombinant human growth hormone（rhGH） therapy in idiopathic short stature （ISS） children in late puberty and the significance of the serum levels of insulin-like gxowth factor-I （IGF- 1） and insulin-like growth factor binding protein-3（IGFBP-3） during rhGH therapy. Methods There were 40 children with ISS in late puberty in this study, rhGH was used to treat these ISS children and their height, weight and bone age were me- asured before and after 6-month therapy. Their serum levels oflGF- 1 and IGFBP-3 after 1-month and 6- month ofrhGH therapy were measured. Results Growth velocity（GV）, height SDS by chronological age（HtSDSCA）, height SDS by bone age （HtSDSBA） and predicting adult height（PAH） increased atter 6-month therapy （P 〈 0.01 ）.The change of the bone age was not significant（P 〉 0.05）. The serum levels oflGF-1 aider 1-month and after 6-month therapy were both higher than those before therapy（P 〈 0.05）.There was no significant difference between the serum level oflGF-1 after one month and after six months of therapy （P 〉 0.05）. There was no significant difference among the serum level of IGFBP-3 before therapy, after 1-month and 6- month of therapy （P 〉 0.05）. The/kHtSDSCA after 6-month therapy was negatively correlated with the serum level oflGF-1 before therapy （P 〈 0.05）;there was a positive correlation between the/klGF-1 after 1-month therapy and the/~ HtSDSCA, the AIGFBP-3 or the AHtSDSBA after 6-month therapy （P 〈 0.05）. There was no apparent adverse reaction during rhGH therapy.Conclusions The rhGH therapy has significant growth promotion effect in ISS children in late puberty, and it is safe. The serum level oflGF-1 can be the good indicator of assessing and predicting GH efficacy.