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目的:探讨胰岛素样生长因子结合蛋白-3(IGFBP-3)与先天性甲状腺功能减低(CH)儿童智力发育的关系。方法:用免疫放射分析法测定IGFBP-3,应用CDCC及C-WYCSl分别对2～岁及3～7岁儿童进行智力测定。结果:①两组儿童智商均在正常范围,但病例组低于正常组(P<0.05)。②IGFBP-3在2～岁儿童中差异无统计学意义(P>0.05),3～7岁儿童中病例组低于正常组(P<0.05)。③在2～岁儿童组中IGFBP-3与智商无统计学相关性(P>0.05),在3～7岁儿童中IGFBP-3与语言智商、韦氏总智商呈正相关(P<0.05)。以IGFBP-3值为因变量,以儿童韦氏各项测验得分为自变量,进行多元逐步回归分析,智能因素中对IGFBP-3水平影响较大的前6位因子分别为图片词汇、领悟、倒背、迷津、视觉分析、顺背。结论:①早期确诊并及时治疗的CH儿童可避免出现智能发育障碍,但仍存在认知方面的损害;②CH儿童经过早期治疗后,血清IGFBP-3水平仍低于正常儿童;③IGFBP-3水平与儿童的语言智商发育更密切;④CH可造成IGFBP-3低水平表达而影响儿童智能发育。
Objective: To investigate the relationship between insulin-like growth factor binding protein-3 (IGFBP-3) and mental development in children with congenital hypothyroidism (CH). Methods: IGFBP-3 was determined by immuno-radioactive assay. The intelligence of children aged 2 ~ 3 years and 3 ~ 7 years old was determined by CDCC and C-WYCSl respectively. Results: ①The IQ of children in both groups were in the normal range, but the cases were lower than the normal group (P <0.05). ② IGFBP-3 in children aged 2 ~ 6 years old had no significant difference (P> 0.05). The cases of children aged 3 ~ 7 years old were lower than the normal group (P <0.05). (3) There was no significant correlation between IGFBP-3 and IQ (P> 0.05) in children aged 2 ~ 4 years. IGFBP - 3 was positively correlated with language IQ and Webster ’s total IQ in children aged 3 ~ 7 years (P <0.05). IGFBP-3 values as the dependent variable, the children’s Wechsler test scores as independent variables, multiple stepwise regression analysis, intelligent factors in the IGFBP-3 level of the larger the six factors were the picture vocabulary, comprehension, Back, maze, visual analysis, Shun back. Conclusion: ① CH children diagnosed early and treated timely can avoid the mental retardation, but there is still cognitive impairment. ② After the early treatment of CH children, serum IGFBP-3 level is still lower than normal children; ③IGFBP-3 levels and Children’s language IQ development more closely; ④ CH can cause low expression of IGFBP-3 and affect children’s intellectual development.