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目的:本文旨在分析生长激素缺乏症患儿应用重组人生长激素治疗后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)以及两者比值(IGF-1/IGFBP-3)三项指标的变化情况及探讨其在疗效评估中的价值。方法:选择2011年1月至2014年2月在我院确诊生长激素缺乏症(growth hormone deficiency,GHD)并接受重组人生长激素(recombinant human growth hormone,rhGH)治疗的矮小患儿44例为研究对象,于治疗前、治疗3个月、治疗6个月分别检测/计算三项指标,分析变化规律,研究其与身高生长速度(growth velocity,GV)的相关性。结果:1.治疗3个月后IGF-1SDS显著增高,但IGFBP-3SDS、IGF-1/IGFBP-3SDS无明显变化;2.治疗6个月后的IGF-1SDS、IGF-1/IGFBP-3SDS明显增高,但IGFBP-3SDS无明显改变;3.治疗3个月的GV与治疗前后的IGF-1、IGFBP-3、IGF-1/IGFBP-3SDS及这三项指标的变化均无明显相关;治疗后6个月GV与治疗前IGF-1SDS呈负相关,而与6个月内的IGF-1SDS变化值呈正相关;GV与治疗前的IGFBP-3、IGF-1/IGFBP-3SDS以及两者6月内的变化值均无明显关系,与治疗6个月后的这三项指标亦无显著相关。结论:IGF-1可能有助于GHD疗效的判断。
Objectives: This study aimed to analyze the changes of serum insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein 3 (IGFBP-3) and the ratio of IGF- -1 / IGFBP-3) changes in the three indicators and explore its value in the evaluation of the efficacy. Methods: Forty-four patients with short stature diagnosed with growth hormone deficiency (GHD) in our hospital from January 2011 to February 2014 and treated with recombinant human growth hormone (rhGH) Subjects, before treatment, 3 months treatment, 6 months treatment were detected / calculated three indicators, analysis of changes in the law to study its relationship with the growth rate (growth velocity, GV). IGF-1SDS, IGF-1 / IGFBP-3SDS had no significant change after 3 months of treatment; 2. IGF-1SDS, IGF-1 / IGFBP-3SDS (P <0.05) .3. There was no significant correlation between GV at 3 months and changes of IGF-1, IGFBP-3, IGF-1 / IGFBP-3SDS before and after treatment, At 6 months after treatment, GV was negatively correlated with pre-treatment IGF-1SDS, but positively correlated with changes of IGF-1SDS within 6 months. Pretreatment IGFBP-3, IGF-1 / IGFBP-3SDS and both There was no significant relationship between the changes in June and the three indexes after 6 months of treatment. Conclusion: IGF-1 may contribute to the judgment of GHD efficacy.