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目的探讨生长激素-胰岛素样生长因子(GH-IGF)轴在先天性心脏病患儿中的变化。方法2004年1~10月在广西医科大学一附院经超声心动图或手术确诊的先天性心脏病患儿50例,应用ELISA方法检测50例患儿及20名健康小儿血中生长激素结合蛋白(GHBP),应用免疫放射分析检测血中胰岛素样生长因子-1(IGF-1)及胰岛素样生长因子结合蛋白-3(IGFBP-3)。结果先天性心脏病患儿血清IGF-1、IGFBP-3质量浓度下降,有紫绀及心衰者下降更为显著;GHBP浓度在有紫绀及心功能不全的患儿中下降。结论先天性心脏病患儿GH-IGF轴发生紊乱,存在生长激素抵抗或不敏感。GHR下调可能是生长激素抵抗或不敏感的分子机制之一。
Objective To investigate the changes of growth hormone-insulin-like growth factor (GH-IGF) axis in children with congenital heart disease. Methods From January to October 2004, 50 children with congenital heart disease diagnosed by echocardiography or surgery in the First Affiliated Hospital of Guangxi Medical University from January 2004 to October 2004 were enrolled. Fifty children and 20 healthy children were tested for growth hormone binding protein (IGFBP-1) and insulin-like growth factor binding protein-3 (IGFBP-3) in blood were detected by immunoradiometric assay (GHBP). Results Serum levels of IGF-1 and IGFBP-3 in children with congenital heart disease decreased significantly, while those with cyanosis and heart failure decreased more significantly. GHBP levels decreased in children with cyanosis and heart failure. Conclusion GH-IGF axis of children with congenital heart disease disorder, there is growth hormone resistance or insensitivity. GHR downregulation may be one of the molecular mechanisms of growth hormone resistance or insensitivity.