胰岛素样生长因子-1在新生儿先天性甲状腺功能减低症的表达应用

目的观察胰岛素样生长因子-1（IGF1）在新生儿先天性甲状腺功能减低症（CH）中的表达及其临床意义。方法选取55例新生儿，其中35例为健康新生儿（对照组），20例为患先天性甲状腺功能减低症的新生儿（试验组），对试验组患儿给予左甲状腺素纳片口服治疗，分别检测对照组以及试验组治疗前、治疗后的血清IGF-1水平及甲状腺功能指标。结果试验组中患儿的血清IGFl水平为（90．6±21．4）ng／mL，对照组中的血清IGF-1水平为（168．6±21．9）ng／mL，试验组水平明显低于对照组；试验组治疗30d和60d后，IGF-1较前升高，但仍然低于对照组的指标；试验组治疗90d后，IGF-1升高到（170．2±20．6）ng／mL，与对照组相比，差异无统计学意义（P〉0．05）。作统计学的直线相关分析后，得出先天性甲状腺功能减低症患儿治疗前、后的IGF-1与游离甲状腺素呈正相关，与促甲状腺激素则呈负相关。结论先天性甲状腺功能减低症的新生儿存在生长激素-胰岛素样生长因子轴（GH—IGF）功能低下，监测IGF-1可有助于甲状腺功能减低症的诊断，经过甲状腺素的替代治疗后，测量IGF-1可判断治疗的效果，总之，监测患儿血清中的IGF-1水平对疾病的诊断、治疗有重大的临床意义。

Expression and application of insulin-like growth factor-1 in newborns with congenital hypothyroidism

Objective To observe the expression and clinical significance of the insulin-like growth factor-1 （IGF-1） in newborns with congenital hypothyroidism（CH）. Methods 55 newborns in our hospital were selected,in cluding 35 normal newborns（control group） and 20 newborns with congenital hypothyroidism（test group）. The test group was given oral levothyroxine（LT4）. The levels of IGF-1 and thyroid function indexes were detected in the nor- mal group and the test group before and after treatment. Results The IGF-1 level was（90.6±21.4） ng/mL in the test group and（168.6±21.9）ng/mL in the control group. The IGF-11evel in the test group was significantly lower than that in the control group. The IGF-1 level after 30 d and 60 d treatment in the test group was increased, but still lower than that in the control group;the IGF-1 level after 90 d treatment in the test group was increased to（170.2± 20.6） ng/mL, there was no statistically significant difference between the control group and the test group（P〉 0.05）. The statistical linear correlation analysis showed that the IGF-1 level before and after treatment in the newbo- rns with CH was positively correlated with FT4 and negatively correlated with TSH. Conclusion The growth hor- mone-insulimlike growth factor axis（GH-IGF） hypofunction.exists in the newborns with CH. Monitoring the IGF-1 level can be conducive to diagnose CH. After thyroxine replace treatment,detecting the IGF-1 level can judge the cur- ative effect. Monitoring serum IGF-1 level has the important significance to the diagnosis and treatment of CH.