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目的通过对使用重组人生长激素(rhGH)患儿进行胰岛素样生长因子-Ⅰ(IGF-Ⅰ)、胰岛素样生长因子结合蛋白(IGFBP3)的监测,探讨rhGH使用的安全性。方法对在本院使用rhGH的患儿30例进行治疗前后血IGF-Ⅰ和IGFBP3浓度监测并计算IGF-Ⅰ和IGFBP3的比值,同时测定T3、T4、TSH,并以年龄、性别匹配20例儿童作为对照组。结果治疗后平均身高增加(8.77±3.01)cm/y(t=7.773,P<0.001)。IGF-Ⅰ治疗前与对照组差异无显著性(t=-0.475,P>0.05),IGFBP3治疗前组高于对照组,差异有显著性(t=3.759,P<0.01),IGF-Ⅰ和IGFBP3治疗后3个月即明显增高,与治疗前相比差异有显著性(t=4.212和7.733,P<0.01)。治疗后IGF-Ⅰ各组之间差异无显著性(f=1.629,P>0.05);IGFBP3各组之间差异有显著性,(f=22.964,P<0.001)与治疗时间呈正相关。IGF-Ⅰ/IGFBP3治疗前后各组之间差异无显著性(f=6.081,P>0.05)。结论在使用rhGH中进行IGF-Ⅰ和IGFBP3监测十分必要;血IGF-Ⅰ和IGFBP3检测方便,可作为rhGH治疗期间是否存在诱发肿瘤高危因素的临床评价指标之一。
Objective To investigate the safety of rhGH by monitoring insulin-like growth factor-Ⅰ (IGF-Ⅰ) and insulin-like growth factor binding protein (IGFBP3) in children with recombinant human growth hormone (rhGH). Methods The levels of IGF-Ⅰand IGFBP3 in 30 children with rhGH in our hospital were measured before and after treatment. The ratio of IGF-Ⅰ to IGFBP3 was calculated, and the levels of T3, T4 and TSH were also measured. Twenty children were matched by age and sex As a control group. Results After treatment, the average height increased (8.77 ± 3.01) cm / y (t = 7.773, P <0.001). There was no significant difference between IGF-Ⅰ and control group before treatment (t = -0.475, P> 0.05), and IGFBP3 before treatment was significantly higher than that of control group (t = 3.759, P <0.01) IGFBP3 significantly increased 3 months after treatment, compared with the pre-treatment difference was significant (t = 4.212 and 7.733, P <0.01). There was no significant difference between the two groups (f = 1.629, P> 0.05). There was a significant difference between IGFBP3 groups (f = 22.964, P <0.001) and treatment time. There was no significant difference between before and after IGF-Ⅰ / IGFBP3 treatment (f = 6.081, P> 0.05). Conclusion It is necessary to monitor IGF-Ⅰ and IGFBP3 in rhGH. The detection of IGF-Ⅰ and IGFBP3 is convenient and can be used as one of the clinical evaluation indexes for inducing tumor risk factors during rhGH treatment.