矮小儿童血清胰岛素样生长因子1和瘦素水平表达及临床意义.docVIP

矮小儿童血清胰岛素样生长因子1和瘦素水平表达及临床意义 　　[摘要] 目的 了解不同病因的矮小儿童血清胰岛素样生长因子-1（IGF-1）和瘦素水平变化，探讨IGF-1和瘦素在生长激素缺乏症（GHD）诊断中的价值。 方法 选择深圳市妇幼保健院就诊的矮小儿童96例，年龄5~11岁，根据身高低于同性别同年龄均值-2~-3SD，排除其他可致身材矮小疾病，根据生长激素激发试验，GH峰值10 ng/mL为GHD者共67例（GHD组）、GH峰值≥10 ng/mL为特发性矮小（ISS）者共29例（ISS组），另选择同期体检的生长发育正常儿童23名作为对照组。采集所有研究对象的外周静脉血3 mL，分离血清后，使用双抗体一步夹心法酶联免疫吸附实验（ELISA）测定血清IGF-1、瘦素浓度。 结果 GHD组血清IGF-1及瘦素水平[（45.7±19.02）μg/L、（4.25±0.63） mg/L]低于ISS组[（114.07±24.45）μg/L、(4.69±0.69) mg/L]和对照组[（164.61±46.22）μg/L、(6.27±0.89) mg/L]），组间比较，差异均有高度统计学意义（P 0.01）；诊断GHD，IGF-1的敏感度为100%，特异度为98%；瘦素的敏感度为88%，特异度为71%。 结论 IGF-1和瘦素的检测可能可作为筛查和诊断GHD有价值的指标，并对GHD与ISS的鉴别诊断也有着一定的临床意义。 　　[关键词] 胰岛素样生长因子-1；瘦素；生长激素缺乏症；特发性矮小 　　[中图分类号] R725[文献标识码] A[文章编号] 1673-7210（2014）06（c）-0038-04 　　 　　Expression and clinical significance of the level of serum insulin-like growth factor-1 and leptin in children with short stature 　　QIU Minghui DONG Guoqing 　　Department of Pediatrics, Shenzhen Maternal and Child Health Care Hospital Affiliated to the Southern Medical University, Guangdong Province, Shenzhen518028, China 　　[Abstract] Objective To understand the levels of serum insulin-like growth factor-1 (IGF-1) and leptin and to discuss the value of IGF-1 and leptin in the diagnosis of growth hormone deficiency (GHD). Methods A total of 96 patients were recruited in Shenzhen Maternity and Child Healthcare Hospital, whose height lower than -2--3SD of the same age and the same sex mean height, to rule out other diseases can cause short stature, according to growth hormone stimulation test, children with GHD whose GH peak 10 ng/mL were as GHD group (n=67), children with idiopathic short stature (ISS) whose GH peak≥10 ng/mL were as ISS group (n=29). The age of patients were at a range of 5-11 years, 23 children aged from 5 to 11 years old whose physical development were natural were chosen as control group. 3 mL peripheral blood of all subjects was chosen as the sample. The concentration of serum IGF-1 and leptin was measured by double antibody step clip art