中国实用儿科杂志

中国实用儿科杂志

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矮小儿童血清生长激素胰岛素样生长因子-1及尿生长激素检测的临床意义

严学勤，魏虹，梁雁，侯凌，张建玲，罗小平   

  1. 华中科技大学同济医院儿科，湖北武汉　430030
  • 收稿日期:2006-02-07 修回日期:2006-03-29 出版日期:2006-07-06 发布日期:2006-07-06

Clinical value of serum insulinlike growth factor 1,serum growth hormone and urinary growth hormone measurement in shortstatured children.

Yan Xueqin,Wei Hong,Liang Yan,et al.   

  1. Department of Pediatrics,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China
  • Received:2006-02-07 Revised:2006-03-29 Online:2006-07-06 Published:2006-07-06

摘要： 目的探讨血清生长激素(GH)、胰岛素样生长因子1(IGF1)及尿GH检测对矮小儿童诊断的意义。 方法华中科技大学同济医院儿科于2004-11—2005-06对106例矮小儿童进行垂体功能复合刺激试验，试验前收集所有受试者夜间12h(20：00~8：00)尿。另选取19例正常青春发育期前儿童为对照组。对垂体功能复合刺激试验GH分泌异常的56例矮小儿童，用ELISA方法检测相应的血清GH、IGF1及尿中GH水平，并进行相关分析。 结果根据垂体功能复合刺激试验的GH检测结果将矮小儿分类，包括完全性GH缺乏症(cGHD)25例、部分性GH缺乏症(pGHD)9例和GH神经分泌功能障碍(GHND)22例。GHD组患儿血清IGF1、尿GH水平与正常儿相比明显降低(P<001)。pGHD和GHND组患儿血IGF1水平波动较大，无统计学差异。GHND组患儿尿GH水平按ng/g肌酐(Cr)计量显著低于正常对照相(P<005)，而按ng/12h尿量计算值虽低于正常组，但无统计学意义(P>005)。pGHD组患儿尿GH水平按两种方法计量值均介于正常和GHD患者之间，与正常及GHD患者比较均有显著性差异(P均<005)。cGHD和pGHD组患儿尿GH的ng/g Cr计量值与其血GH峰值呈显著性正相关(rcGHD=0556,P<005；rpGHD=0423,P<005)，GHND组患儿尿GH的ng/g Cr计量值与其血中GH峰值无相关性(P>005)。 结论尿GH水平测定无创、简便，配合IGF1等指标的检测，对于矮小儿童的诊断和鉴别诊断具有重要意义。

关键词: 胰岛素样生长因子1, 血清生长激素, 尿生长激素, 矮小儿童

Abstract: To investigate the significance of serum growth hormone,serum insulinlike growth factor1(IGF1) and urinary growth hormone(GH)levels in the diagnosis of short statured children. MethodsFrom Nov.2004-Jun.2005 to 106 short statured children and 19 normal children in prepuberty were selected,each having 12h (8：00pm~8：00AM) urine collection.The short statured children were given combined pituitary hormone provocating tests,and the corresponding serum GH，IGF1 and urinary GH were determined by ELISA kits. ResultsAccording to the serum GH levels of provocating tests,the shortstatured children were divided into three groups：complete growth hormone deficiency (cGHD) 25 cases,partial growth hormone deficiency(pGHD) 9 cases,disorders of growth hormone neurosecretion (GHND) 22 cases.IGF1 and urinary GH in cGHD groups were remarkably lower than those in normal children(P<001).IGF1 value of pGHD and GHND group fluctuated comparatively greatly,so there was no statistical significance compared to normal children.Urinary GH pg/mg creatinine(Cr)count in GHND group had significant difference vs.normal group(P<005)， although urinary GH ng/12h count value was lower than normal group，there is no statistical significance(P>005).The two kinds of urinary GH in pGHD group were between normal and cGHD，and there was predominant difference vs.normal group (P mean <005).Urinary GH pg/mg Cr count in cGHD and pGHD groups were positively correlated with the serum GH peak (rcGHD=0556,P<005; rpGHD=0423,P<005),respectively. ConclusionSerum IGF1 and urinary GH levels have important significance in the diagnosis of short statured children.

Key words: Short statured children , Serum growth hormone, Urinary growth hormone