血清IGF-1和IGFBP-3及ALP在重组人生长激素治疗特发性矮小和特纳综合征中变化水平的观察

 目的 用重组人生长激素（rhGH）治疗特发性矮小（ISS）和Turner syndrome（TS）患儿，观察血清胰岛素样生长因子-1（insulin-like growth factor -1，IGF-1）、胰岛素样生长因子结合蛋白-3（IGFBP-3）及血碱性磷酸酶（ALP）在ISS和TS中的临床应用价值。方法　对rhGH治疗的ISS患儿31例和TS患儿17例进行治疗前后血清IGF-1、IGFBP-3及ALP浓度监测，观察治疗前后的变化。结果　ISS和TS患儿经rhGH治疗后IGF-1与IGFBP-3明显升高，6个月时达高峰，之后基本维持在较高水平；IGF-1与IGFBP-3的比值治疗后显著升高（F=6.739，P＜0.01），以IGF-1升高更明显；ISS和TS患儿经rhGH治疗后血清ALP也明显上升，3个月时达高峰，之后基本维持在较高水平；血清ALP与IGF-1和IGFBP-3在治疗前后各个时间段不存在显著相关性。结论　ISS和TS患儿经rhGH治疗后，血清IGF-1、IGFBP-3及ALP水平均升高，并基本维持在较高水平，IGF-1较IGFBP-3升高更为明显；治疗起始3个月血清ALP反应敏感，血清ALP尚不能作为替代IGF-1和IGFBP-3监测rhGH治疗疗效的指标。

Serum Insulin-like Growth Factor-1,Insulin-like Growth Factor Binding Protein-3 and Alkaline Phosphatase Monitoring in rhGH-treated ISS and TS Children

Objective To observe clinical value of serum insulin-like growth factor-1(IGF-1),insulin-like growth factor-binding protein-3(IGFBP-3) and alkaline phosphatase(ALP) in rhGH-treated idiopathic short stature(ISS) and Turner syndrome(TS) children.Methods Serum IGF-1,IGFBP-3 and alkaline phosphatase level variation trend in rhGH-treated children,including 31 ISS and 17 TS,were monitored before and after the treatment.Results IGF-1 and IGFBP-3 level significantly increased after treatment,reach a peak after 6 months,and then IGF-1 maintenance at high level;IGF-1and IGFBP-3 ratio significantly increased after treatment;ALP level significantly increased after treatment,reach a peak after 3 months of both ISS and TS;ALP is not correlated with IGF-1 or IGFBP-3.Conclusion IGF-1,IGFBP-3 and ALP level increased after the rhGH treatment and maintenance at high level in both ISS and TS children;IGF-1 increased more than IGFBP-3;ALP was sensitive to rhGH treatment,serum ALP could not be as a parameter of monitoring efficacy of rhGH treatment.