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目的观察特发性矮小(ISS)患儿血中生长激素(GH)、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)及生长激素结合蛋白(GHBP)水平的变化。方法2002年6月至2006年5月在中南大学湘雅二医院儿科就诊的37例ISS患儿为病例组,37例年龄性别相匹配的正常儿童为对照组。采用放射免疫分析法(RIA)测定血清GH,免疫放射计量法(IRMA)测定血清IGF-1及IGFBP-3,葡聚糖覆盖炭末吸附法(DCT)检测血清GHBP。结果ISS组血清GHBP、IGF-1、IGFBP-3均明显低于对照组(均P<0.01),而血清GH基础值在ISS组明显高于对照组(P<0.05)。结论ISS患儿血中IGF-1和IGFBP-3降低可能是其矮小的原因之一。ISS患儿血中反映生长激素受体(GHR)水平的GHBP降低,而GH基础值升高,提示可能存在因GHR缺陷导致的GH不敏感。
Objective To observe the changes of blood levels of growth hormone (GH), insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3) and growth hormone binding protein GHBP) level changes. Methods From June 2002 to May 2006, 37 ISS children treated in pediatrics department of Xiangya Second Hospital of Central South University were selected as case group and 37 age-matched normal children as control group. Serum GH was measured by radioimmunoassay (RIA), serum IGF-1 and IGFBP-3 were measured by radioimmunoassay (IRMA), and serum GHBP was detected by dextran-coated charcoal adsorption method (DCT). Results The levels of serum GHBP, IGF-1 and IGFBP-3 in ISS group were significantly lower than those in control group (all P <0.01), while the serum GH basal levels in ISS group were significantly higher than those in control group (P <0.05). Conclusion The decrease of IGF-1 and IGFBP-3 in children with ISS may be one of the reasons for its shortness. In children with ISS, serum GHBP, which reflects the level of growth hormone receptor (GHR), is decreased, whereas elevated basal GH levels suggest that there may be GH insensitivity due to GHR deficiency.