CAJ | 학술논문

目的：探讨性早熟患儿血清胰岛素样生长因子-1（IGF-1）、胰岛素样生长因子结合蛋白3（IGFBP3）和促黄体生成素（ LH）峰值的水平变化，分析其对儿童性早熟的诊断价值，为临床诊治、观察病情和疗效提供理论依据。方法收集儿童保健科就诊的性早熟女童69例， ICPP组26例， SPT组43例。同时收集青春发育前健康女童30例为对照。用化学发光法检测ICPP组、SPT组、对照组血清IGF-1、IGFBP3水平和血清LH峰值水平。结果 ICPP组血清IGF-1水平[（451±148）ng/ml]明显高于SPT组[（268±56）ng/ml]和对照组[（141±69）ng/ml]，差异有统计学意义（ P ＜0．05）。 SPT组IGF-1[（268±56）ng/ml]水平明显高于对照组，差异有统计学意义（ P ＜0．05）。 ICPP组患儿血清IGFBP3水平[（5．7±1．0）ng/ml]与SPT组[（5．3±0．5）ng/ml]水平明显高于对照组[（4．2±1．3）ng/ml]，差异有统计学意义（ P ＜0．05）。ICPP组患儿血清LH峰值水平[（27．2±22．7）U/L]明显高于SPT组[（3．2±1．9）U/L]，差异有统计学意义（ P ＜0．05）。结论 IGF-1、IGFBP3可作为性早熟的诊断依据，IGF-1对ICPP和SPT有鉴别诊断意义。 LH峰值明显升高可能与CPP女童HPG轴功能提前激活有一定关系。
목적：탐토성조숙환인혈청이도소양생장인자-1（IGF-1）、이도소양생장인자결합단백3（IGFBP3）화촉황체생성소（ LH）봉치적수평변화，분석기대인동성조숙적진단개치，위림상진치、관찰병정화료효제공이론의거。방법수집인동보건과취진적성조숙녀동69례， ICPP조26례， SPT조43례。동시수집청춘발육전건강녀동30례위대조。용화학발광법검측ICPP조、SPT조、대조조혈청IGF-1、IGFBP3수평화혈청LH봉치수평。결과 ICPP조혈청IGF-1수평[（451±148）ng/ml]명현고우SPT조[（268±56）ng/ml]화대조조[（141±69）ng/ml]，차이유통계학의의（ P ＜0．05）。 SPT조IGF-1[（268±56）ng/ml]수평명현고우대조조，차이유통계학의의（ P ＜0．05）。 ICPP조환인혈청IGFBP3수평[（5．7±1．0）ng/ml]여SPT조[（5．3±0．5）ng/ml]수평명현고우대조조[（4．2±1．3）ng/ml]，차이유통계학의의（ P ＜0．05）。ICPP조환인혈청LH봉치수평[（27．2±22．7）U/L]명현고우SPT조[（3．2±1．9）U/L]，차이유통계학의의（ P ＜0．05）。결론 IGF-1、IGFBP3가작위성조숙적진단의거，IGF-1대ICPP화SPT유감별진단의의。 LH봉치명현승고가능여CPP녀동HPG축공능제전격활유일정관계。
Objective To investigate the changes of serum levels of IGF-1,IGFBP3 and LH in woman children with central precocious puberty (CPP) to provide the theoretical basis for clinical diagnosis and treatment .Methods Sixty-nine woman children with CPP,26 cases of idiopathic central precocious puberty (ICPP),43 cases of simple breast development (SPT) were enrolled in the investigation,meanwhile,30 healthy woman subjects were enrolled as control group .The serum levels of IGF-1,IGFBP3 and LH were detected by electrochemiluminescence method for the four groups .Results The serum levels [(451 ±148)ng/ml] of IGF-1 in ICPP group were significantly higher than those [(268 ±56)ng/ml] in SPT group and those [(141 ±69)ng/ml] in control group ( P <0.05).The serum levels [(268 ±56)ng/ml] of IGF-1 in SPT group were significantly higher than those in control group ( P <0.05).The serum levels [(5.7 ±1.0)ng/ml] of IGFBP3 in ICPP group and those [(5.3 ±0.5) ng/ml] in SPT group were significantly higher than those [(4.2 ±1.3) ng/ml] in control group ( P <0.05).The peak levels [(27.2 ±22.7)U/L] of LH in ICPP group were significantly higher than those [(3.2 ± 1.9)U/L] in SPT group ( P <0.05).Conclusion IGF-1 and IGFBP3 can be regarded as diagnostic basis for diagnosis of sexual precosity ,IGF-1 has the significance of differential diagnosis for ICPP and SPT .The obvious enhancement of LH peak may be correlated to HPG activation in advance of axis function in woman children with CPP .