CAJ | 학술논문

目的观察难治性肾病综合征(RNS)患儿生长激素(GH)-胰岛素样生长因子(IGF)轴的变化及意义。方法计算26例RNS患儿的身高标准差积分(HtSDS)，以双抗放射免疫法和免疫放射法检测血、尿IGF-I及其结合蛋白-3(IGFBP-3)水平和血GH基础值，以同年龄组正常儿童(NC组，n=18)作对照。结果 RNS组血IGF-I(152.68±120.95) ng/ml，IGFBP-3(2 183.33±1 711.33) ng/ml低于NC组(255.68±46.92) ng/ml，(4 333.87±1 122.00) ng/ml，(P<0.05)，尿IGF-I(5.32±2.84) ng/mg肌酐，IGFBP-3(16.38±8.55) ng/mg肌酐高于NC组(0.90±0.37) ng/mg肌酐，(5.13±1.64) ng/mg肌酐，(P<0.05)；RNS组的血GH水平虽低于NC组，但P>0.05。RNS组身高标准差积分(HtSDS)(-0.42±0.75)低于NC组(0.30±0.17)，(P<0.05)。结论 RNS患儿存在GH-IGF轴的变化，此变化为RNS患儿生长障碍的主要原因之一。
목적관찰난치성신병종합정(RNS)환인생장격소(GH)-이도소양생장인자(IGF)축적변화급의의。방법계산26례RNS환인적신고표준차적분(HtSDS)，이쌍항방사면역법화면역방사법검측혈、뇨IGF-I급기결합단백-3(IGFBP-3)수평화혈GH기출치，이동년령조정상인동(NC조，n=18)작대조。결과 RNS조혈IGF-I(152.68±120.95) ng/ml，IGFBP-3(2 183.33±1 711.33) ng/ml저우NC조(255.68±46.92) ng/ml，(4 333.87±1 122.00) ng/ml，(P<0.05)，뇨IGF-I(5.32±2.84) ng/mg기항，IGFBP-3(16.38±8.55) ng/mg기항고우NC조(0.90±0.37) ng/mg기항，(5.13±1.64) ng/mg기항，(P<0.05)；RNS조적혈GH수평수저우NC조，단P>0.05。RNS조신고표준차적분(HtSDS)(-0.42±0.75)저우NC조(0.30±0.17)，(P<0.05)。결론 RNS환인존재GH-IGF축적변화，차변화위RNS환인생장장애적주요원인지일。
Objective　To observe the variation of GH-IGF axis in children with the refractory nephrotic syndrome (RNS). Methods　Serum and urine levels of IGF-I and IGFBP-3 and baseline serum levels of GH were assayed using RIA and IRMA in 26 patients with RNS, and hight standard deviation score (HtSDS) was calculated. Eighteen healthy children of similar ages were used as the control group (NC group). Results　Serum IGF-I ［(152.68±120.95) ng/ml］ and IGFBP-3 ［(2 183.33±1 711.33) ng/ml］ levels in the RNS group were significantly lower than those of the NC group ［(255.68±46.92) ng/ml, 4 333.87±1 122.00) ng/ml］ (P<0.05), and urine IGF-I ［(5.32±2.84) ng/mg creatinine］ and IGFBP-3 ［(16.38±8.55) ng/mg creatinine］ levels were higher than those of the NC group ［(0.90±0.37) ng/mg creatinine, (5.13±1.64) ng/mg creatinine］ (P<0.05). The serum GH level was lower than that of the NC group, but didn't achieve any statistical significance. HtSDS (-0.42±0.75) of the RNS group was lower than that of the NC group (0.30±0.17)(P<0.05). Conclusions　A disorder of the GH-IGF axis was detected in children with RNS. This abnormality may contribute to the growth failure seen in RNS.