性早熟女性患儿血清IGF-1和IGFBP-3质量浓度检测及临床价值

目的　探讨女性特发性中枢性性早熟(ICPP)及乳房早发育患儿血清胰岛素样生长因子 1 (IGF- 1 )和胰岛素样生长因子结合蛋白 3 (IGFBP -3 )的关系及临床意义。方法　以放射免疫法测定于2 0 0 0年5月至2 0 0 4年1月在暨南大学医学院第二附属医院就诊的2 2例ICPP及2 8例乳房早发育女孩血清IGF- 1和IGFBP -3的水平,并以2 5名正常青春发育期女孩及3 0名未发育女孩作为对照,以IGF- 1、IGFBP- 3为诊断指标,对ICPP进行诊断试验评价。结果　ICPP女性患儿血清IGF -1、IGFBP- 3水平均明显高于乳房早发育及未发育女孩(P <0 .0 1 ) ,而与正常青春发育女孩差别无显著性意义(P >0 .0 5)。IGF- 1 >2 69 .1 4mg/L对诊断ICPP的灵敏度、特异度、阳性预测值、准确度分别为95% ,96% ,95% ,96% ;IGFBP -3 >3 53 6 42mg/L对诊断ICPP的灵敏度、特异度、阳性预测值、准确度分别为72 % ,96% ,94% ,86%。结论　ICPP女性患儿血清IGF 1、IGFBP- 3水平明显增高,IGF -1、IGFBP -3对鉴别ICPP与乳房早发育具有临床意义。

Changes of serum insulin-like growth factor 1 and insulin-like growth factor binding protein 3 in the female patients with precocious puberty

Objectives To investigate the changes and clinical significance of serum insulin-like growth factor 1(IGF-1) and insulin-like growth factor binding protein 3 (IGFBP-3) in the female patients with idiopathic central precocious puberty (ICPP) and premature thelarche. Methods The serum IGF-1 and IGFBP-3 were detected by radioimmunoassay in 22 female patients with ICPP and 28 patients with premature thelarche. 25 children with normal puberty and 30 underdeveloped children were as control groups. The diagnostic value of IGF-1 and IGFBP-3 was evaluated in the patients with ICPP. Results The serum levels of IGF-1 and IGFBP-3 in the patients with ICPP were significantly higher than those of children with premature thelarche and the underdeveloped(P<0.01). There was no significant difference between ICPP and the normal puberty groups(P>0.05). The sensitivity, specificity, positive predictive value and accuracy were 95%, 96%, 95% and 96% respectively for the diagnosis of ICPP when the serum IGF-1 was above 269.14 mg/L,the sensitivity, specificity, positive predictive value and accuracy were 72%, 96%, 94% and 86% respectively for diagnosis of ICPP when the serum IGFBP-3 was above 3536.42 mg/L. Conclusion The serum level of IGF-1 and IGF-3 increases in the female patients with ICPP. IGF-1 and IGFBP-3 are useful for differential diagnosis of ICPP with premature thelarche.