摘要
目的 分析特发性矮小症(ISS)患儿血清骨特异性碱性磷酸酶(BAP)、胰岛素样生长因子1(IGF-1)及胰岛素样生长因子结合蛋白3(IGFBP-3)变化及与重组人生长激素(rhGH)的相关性。方法 选取南阳市中心医院2019年6月至2021年3月间97例ISS患儿为ISS组,纳入同期来院体检的100名健康体检儿童资料为健康对照组,比较两组受试者一般临床资料及血清BAP、IGF-1及IGFBP-3水平,分析血清BAP、IGF-1及IGFBP-3对ISS的诊断价值。ISS组患儿入院后均给予rhGH治疗,治疗12个月后,根据治疗效果将ISS组患儿分为显效组、有效组和无效组,比较三亚组患儿血清BAP、IGF-1及IGFBP-3水平。结果 ISS组和健康对照组性别、年龄比较,差异无统计学意义(P>0.05),ISS组身高、体重、BAI、BAD均显著低于健康对照组,差异均有统计学意义(P<0.05)。血清BAP、IGF-1及IGFBP-3水平均显著低于健康对照组,差异均有统计学意义(P<0.05)。ROC分析显示,血清BAP、IGF-1及IGFBP-3单独及联合诊断小儿ISS的AUC分别为0.928、0.968、0.921、0.973,敏感度为97.0%、87.0%、82.0%、87.7%,特异度为91.8%、94.8%、93.8%、95.2%,联合诊断价值更高。rhGH治疗12个月后,血清BAP、IGF-1及IGFBP-3水平:显效组>有效组>无效组,差异均有统计学意义(P<0.05)。结论 ISS患儿血清BAP、IGF-1及IGFBP-3水平均显著偏低,三者可作为ISS临床诊断和rhGH治疗的疗效评估指标。
Objective To analyze the changes of serum bone-specific alkaline phosphatase(BAP),insulin-like growth factor-1(IGF-1)and insulin-like growth factor-binding protein-3(IGFBP-3)in children with idiopathic short stature(ISS)and their correlation with the therapeutic effect of recombinant human growth hormone(rhGH). Methods 97 children with ISS in Nanyang Central Hospital between June 2019and March 2021 were selected as the ISS group,and 100 healthy children who received physical examination during the same period were included as the healthy group. The general clinical data and the levels of serum BAP,IGF-1 and IGFBP were compared between the two groups of subjects,and the diagnostic value of serum BAP,IGF-1 and IGFBP-3 on ISS was analyzed. The children in the ISS group were all given rhGH treatment after admission. After 12 months of treatment,the children in the ISS group were divided into the markedly effective group,the effective group and the ineffective group according to the treatment effect,and the levels of serum BAP,IGF-1 and IGFBP-3. Results There was no statistical difference in gender and age between the two groups(P>0.05). The height,weight,BAI and BAD in the ISS group were significantly lower or lighter than those in the healthy group(P<0.05). Serum BAP,IGF-1 and IGFBP-3 levels were significantly lower than those in the healthy group(P<0.05). ROC analysis showed that the AUCs of serum BAP,IGF-1 and IGFBP-3 alone and in combination for the diagnosis of ISS in children were 0.928,0.968,0.921,0.973,the sensitivities were 97.0%,87.0%,82.0%,87.7%,and the specificities were 91.8%,94.8%,93.8%,95.2%,the combined diagnosis value is higher. After 12 months of rhGH treatment,the levels of serum BAP,IGF-1 and IGFBP-3 of children in the markedly effective group were significantly higher than those in the effective group and the ineffective group(P<0.05).Conclusion Serum levels of BAP,IGF-1 and IGFBP-3 in children with ISS were significantly lower,and the three can be used as indicators for clinical diagnosis of ISS and efficacy evaluation of rhGH treatment.
作者
牛文忠
吴琼
陈朴
李正一
张贵春
赵丽丽
丁显春
NIU Wenzhong;WU Qiong;CHEN Pu;LI Zhengyi;ZHANG Guichun;ZHAO Lili;DING Xianchun(Department of Pediatric Nephrology/Endocrinology,Nanyang Central Hospital,Nanyang,Henan,China,473000)
出处
《分子诊断与治疗杂志》
2023年第1期18-21,25,共5页
Journal of Molecular Diagnostics and Therapy
基金
河南省科技发展计划项目(182102310312)。
