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目的探讨胰岛素样生长因子1(IGF-1)生成试验对特发性矮小(ISS)患儿的诊断和治疗价值。方法将15例ISS患儿分为IGF-1生成/基础比值≥3的无生长激素不敏感(GHI)组(A组,4例)和IGF-1生成/基础比值<3的部分GHI组(B组,11例)。比较两组患儿接受重组人生长激素(rhGH)治疗后的生长速率,分析IGF-1生成试验中IGF-1反应水平与生长速率的关系。结果 rhGH治疗6个月后,A组与B组生长速率无统计学差异[(12.1±1.3)cm/年vs.(11.0±1.6)cm/年](P>0.05)。B组IGF-1生成试验中,IGF-1反应水平与生长速率无相关性(r=0.596,P>0.05)。结论 IGF-1生成试验可为明确ISS病因提供参考,但作为独立预测rhGH对ISS患儿促生长疗效的指标有待于进一步研究。
Objective To investigate the diagnostic and therapeutic value of insulin-like growth factor 1 (IGF-1) production in idiopathic short stature (ISS) children. Methods Fifteen children with ISS were divided into GHI group (group A, 4 cases) with IGF-1 production / basal ratio ≥3 and partial GHI group with IGF-1 production / basal ratio <3 B group, 11 cases). The growth rate of the two groups of children treated with recombinant human growth hormone (rhGH) was compared and the relationship between IGF-1 response and growth rate in IGF-1 production assay was analyzed. Results After 6 months of rhGH treatment, there was no significant difference in growth rate between group A and group B (12.1 ± 1.3 cm / year vs 11.0 ± 1.6 cm / year) (P> 0.05). There was no correlation between IGF-1 level and growth rate in group B IGF-1 production (r = 0.596, P> 0.05). Conclusion The IGF-1 production test may provide a reference for elucidating the etiology of ISS. However, further studies are needed to predict the effect of rhGH on the growth of children with ISS.