脑瘫患儿血清中IGF-1水平的变化及其临床意义
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摘要
目的探讨脑瘫患儿血清胰岛素样生长因子-1(insulin-like growth factor-1,IGF-1)水平的变化及其临床意义。方法以入院确诊为脑瘫的95例患儿为脑瘫组(CP组),选择同期体检健康的30例儿童为对照组,于入院后抽取静脉血,用化学发光免疫法测定其血清中的IGF-1含量,分析其与脑瘫发病程度的关系。结果①脑瘫患儿血清中IGF-1水平分别为(33.96±2.73)μg/L,对照组为(65.23±5.97)μg/L,两组间比较有显著性差异(P均<0.05);②不同浓度IGF-1对应的患儿粗大运动、精细动作、语言能力、社交行为及GMFM间评分两两比较均有显著差异(P<0.05),与社会适应能力两两比较无显著差异(P>0.05)。结论脑瘫患儿血清中IGF-1含量明显下降,且血清IGF-1与患儿粗大运动、精细动作、语言能力、社交行为水平呈正相关,血清中IGF-1浓度水平可作为评价脑瘫患儿脑损伤程度指标。
Objective To investigate the changes and clinical significance of serum insulin-like growth factor(IGF-1) levels inchildren with cerebral palsy. Methods Ninety-five patients diagnosed as cerebral palsy by admission were cerebral palsy group(CPgroup). 30 children with physical examination health check were selected as control group. Venous blood was collected after admissionand chemiluminescence immunoassay were used. Serum levels ofIGF-1 were measured, and the relationship between index anddegree of cerebral palsy was analyzed. Results ① Serum levels of IGF1 in children with cerebral palsy were(19.62±6.73) μg/L and(33.96±2.73) μg/L, respectively, and in the control group were(13.58±2.36) μg/L and(65.23±5.97), there was a significant differencebetween the two groups(P<0.05); ② The scores of gross movement, fine movement, language ability and social behavior of childrenwith different concentrations of IGF-1 were significantly different(P<0.05). Conclusion The serum IGF1 concentration in childrenwith cerebral palsy is significantly decreased, serum IGF-1 was positively correlated with children's gross motor, fine movements,language ability and social behavior.Serum IGF-1 can be used as indexes to evaluate brain injury in children with cerebral palsy.
Objective To investigate the changes and clinical significance of serum insulin-like growth factor(IGF-1) levels inchildren with cerebral palsy. Methods Ninety-five patients diagnosed as cerebral palsy by admission were cerebral palsy group(CPgroup). 30 children with physical examination health check were selected as control group. Venous blood was collected after admissionand chemiluminescence immunoassay were used. Serum levels ofIGF-1 were measured, and the relationship between index anddegree of cerebral palsy was analyzed. Results ① Serum levels of IGF1 in children with cerebral palsy were(19.62±6.73) μg/L and(33.96±2.73) μg/L, respectively, and in the control group were(13.58±2.36) μg/L and(65.23±5.97), there was a significant differencebetween the two groups(P<0.05); ② The scores of gross movement, fine movement, language ability and social behavior of childrenwith different concentrations of IGF-1 were significantly different(P<0.05). Conclusion The serum IGF1 concentration in childrenwith cerebral palsy is significantly decreased, serum IGF-1 was positively correlated with children's gross motor, fine movements,language ability and social behavior.Serum IGF-1 can be used as indexes to evaluate brain injury in children with cerebral palsy.
引文
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[15]朱登纳,贾延劼,王军,等.人胰岛素样生长因子-1基因修饰的神经干细胞移植对缺氧缺血性脑损伤新生大鼠的治疗作用[J].中华实用儿科临床杂志,2011,26(16):1279-1282.
[2]马秀伟,封志纯.脑瘫诊断面面观[J].中国儿童保健杂志,2014,22(1):41-44.
[3]李晓捷,唐久来,马丙祥,等.脑性瘫痪的定义、诊断标准及临床分型[J].中华实用儿科临床杂志,2014,29(19):1520-1520.
[4]杜娇娇,张丽华,周志国.脑瘫患儿血清IGF-1、GLU、GABA含量的研究[J].中国伤残医学,2007,15(2):2-4.
[5]Devesa J,Casteleiro N,Rodicio C,et al.Growth hormone deficiency and cerebral palsy[J].Therapeutics&Clinical Risk Management,2010,6(1):413-418.
[6]Nieto‐Estévez V,Oueslati‐Morales C O,Li L,et al.Brain Insulin‐Like Growth Factor‐I Directs the Transition from Stem Cells to Mature Neurons During Postnatal/Adult Hippocampal Neurogenesis[J].Stem Cells,2016,34(8):2194-2209.
[7]吴至凤,赵聪敏,廖伟,等.生长激素/胰岛素样生长因子-1轴与脑瘫儿童认知、大运动功能的关系[J].第三军医大学学报,2016,38(8):863-867.
[8]Nazif H,Shatla R,Elsayed R,et al.Bone mineral density and insulin-like growth factor-1 in children with spastic cerebral palsy[J].Childs Nervous System,2017,33(4):625-630.
[9]武楠,陈婷,林丽星.缺氧缺血性脑病中胰岛素样生长因子-1的研究进展[J].临床儿科杂志,2017,35(11):868-872.
[10]Yang X,Wei A,Liu Y,et al.IGF-1 protects retinal ganglion cells from hypoxiainduced apoptosis by activating the Erk-1/2 and Akt pathways[J].Molecular Vision,2013,19(6):1901-1912.
[11]Stemkowski P L,Zamponi G W.The tao of IGF-1:insulin-like growth factor receptor activation increases pain by enhancing T-type calcium channel activity[J].Science Signaling,2014,7(346):pe23.
[12]Hong H,Cui Z Z,Zhu L,et al.Central IGF1 improves glucose tolerance and insulin sensitivity in mice[J].Nutrition&Diabetes,2017,7(12-22).
[13]杨毅,马力.生长激素和胰岛素样生长因子与小儿免疫系统发育的研究[J].中华儿科杂志,1998,36(6):331-333.
[14]朱登纳,王军,贾延劼,等.人胰岛素样生长因子-1真核表达载体的构建及在神经干细胞中的表达[J].郑州大学学报(医学版),2012,47(2):156-159.
[15]朱登纳,贾延劼,王军,等.人胰岛素样生长因子-1基因修饰的神经干细胞移植对缺氧缺血性脑损伤新生大鼠的治疗作用[J].中华实用儿科临床杂志,2011,26(16):1279-1282.