中枢性性早熟幼女性激素、IGF-1与生长发育的临床关系探讨
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摘要
目的探讨中枢性性早熟幼女中性激素、促生长因子-1(IGF-1)与生长发育的临床关系。方法分别选取湖南省湘潭市中心医院2016年1月~2017年3月接收的中枢性性早熟、正常健康幼女,各26例。分别记为疾病组与健康组,均抽取外周静脉血检测性激素、IGF-1的水平,测量并对比身高、骨龄、卵巢和子宫容积。采用Pearson相关性分析法分析疾病组患儿性激素、IGF-1水平与身高、骨龄、卵巢和子宫容积的关系。结果疾病组血清卵泡刺激素(FSH)、促黄体生成素(LH)、雌二醇(E2)和IGF-1均高于健康组,差异均有统计学意义(P<0.01);疾病组身高、骨龄、卵巢和子宫容积均高于健康组,差异均有统计学意义(P<0.01);在疾病组中,血清FSH、LH、E2和IGF-1与身高、骨龄、卵巢和子宫容积均呈正相关(r>0.3,P<0.05)。结论在中枢性性早熟女童中,血清FSH、LH、E2和IGF-1均异常升高,且可对生长发育造成影响,导致矮小,骨龄、卵巢和子宫容积均增大。
Objective To investigate the relationships between growth hormone,inslin-like growth inslin-like factor-1(IGF-1) with growth and development in children with central precocious puberty.Methods Each 26 cases of central precocious puberty and normal healthy young girls in Xiangtan Central Hospital of Hunan Province from January 2016 to March2017 were selected as the disease group and the healthy group respectively.The levels of sex hormones and IGF-1 were measured by peripheral venous blood,and the stature,bone age,ovary and uterus volume were measured and compared.The Pearson correlation analysis method was used to analyze the clinical relationships between the neutral hormone,IGF-1 and the growth,bone age,ovary and uterus volume in the disease group.Results The levels of serum FSH,luteinizing hormone(LH),estradiol(E2) and IGF-1 in the disease group were higher than those in the healthy group,and the differences were statistically significant(P < 0.01).The height,bone age,ovary and uterus volume in the disease group were higher than those in the healthy group,the differences were statistically significant(P < 0.01).In the disease group,the serum FSH,LH,E2 and IGF-1 levels were positively correlated with height,bone age,ovary and uterus volume(r > 0.3,P < 0.05).Conclusion In girls with central precocious puberty,the serum levels of FSH,LH,E2 and IGF-1 are abnormally high,which can affect growth and development,lead to short stature,and increase bone age,ovary and uterus volume.
Objective To investigate the relationships between growth hormone,inslin-like growth inslin-like factor-1(IGF-1) with growth and development in children with central precocious puberty.Methods Each 26 cases of central precocious puberty and normal healthy young girls in Xiangtan Central Hospital of Hunan Province from January 2016 to March2017 were selected as the disease group and the healthy group respectively.The levels of sex hormones and IGF-1 were measured by peripheral venous blood,and the stature,bone age,ovary and uterus volume were measured and compared.The Pearson correlation analysis method was used to analyze the clinical relationships between the neutral hormone,IGF-1 and the growth,bone age,ovary and uterus volume in the disease group.Results The levels of serum FSH,luteinizing hormone(LH),estradiol(E2) and IGF-1 in the disease group were higher than those in the healthy group,and the differences were statistically significant(P < 0.01).The height,bone age,ovary and uterus volume in the disease group were higher than those in the healthy group,the differences were statistically significant(P < 0.01).In the disease group,the serum FSH,LH,E2 and IGF-1 levels were positively correlated with height,bone age,ovary and uterus volume(r > 0.3,P < 0.05).Conclusion In girls with central precocious puberty,the serum levels of FSH,LH,E2 and IGF-1 are abnormally high,which can affect growth and development,lead to short stature,and increase bone age,ovary and uterus volume.
引文
[1]中华医学会儿科学分会内分泌遗传代谢学组.第十二届中华医学会儿科学分会内分泌遗传代谢病学术会议纪要[J].中华儿科杂志,2013,51(8):638-640.
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[5]李莉.血清IGF-1、IGFBP-3与生长激素治疗SGA矮小患儿的疗效[J].热带医学杂志,2016,16(4):493-495.
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[7]程炳娟,刘戈力,李宁,等.特发性矮小生长激素受体外显子3基因多态性与生长激素轴的关系[J].天津医药,2016,44(1):78-82.
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[9]曾婷,李红辉,严提珍,等.柳州市特发性矮小症瑶族学龄儿童维生素D和IGF-1水平与体格发育指标的相关性分析[J].职业与健康,2017,33(6):794-796.
[10]赵艳琼,蔡秋玲,王鲁宁,等.广西汉壮瑶族儿童体能发育及其与IGF-1和IGFBP-3的相关性[J].中国学校卫生,2016,37(12):1763-1767.
[11]Sava觭s-Erdeve觭S,觭S覦klar Z,Hac覦hamdioglu B,et al.Gonadotropin-Releasing Hormone Analogue Treatment in Females with Moderately Early Puberty:No Effect on Final Height.[J].J Clin Res Pediatr Endocrinol,2016,8(2):211-117.
[12]金献江,罗越,吴慧平.促性腺激素释放激素类似物对特发性中枢性性早熟女童体质指数及骨代谢标志物水平的影响[J].中国全科医学,2016,19(9):1049-1052.
[13]周雪莲,傅君芬,金菊花,等.肥胖对中枢性性早熟女童Gn RH激发试验促黄体生成素峰值及相关激素的影响[J].中国当代儿科杂志,2015,17(8):763-768.
[14]吴慧平,金献江,罗越,等.骨代谢标志物在特发性中枢性性早熟女童血清中的变化及意义[J].浙江医学,2015,37(16):1347-1349.
[15]鱼建飞,马晓鹏,梅林华,等.特发性性早熟女童治疗前后血清性激素及IGF-1水平的研究[J].中国性科学,2017,26(4):81-84.
[16]Huguelet PS,Browner-Elhanan KJ,Fleming N,et al.Does the North American Society for Pediatric and Adolescent Gynecology Short Curriculum Increase Resident Knowledge in Pediatric and Adolescent Gynecology?[J].J Pediatr Adolesc Gynecol,2016,29(6):623-627.
[17]汪培欢,施弦.曲普瑞林对特发性中枢性性早熟女童治疗作用的自身前后对照观察[J].中国性科学,2016,25(3):59-62.
[18]唐家彦,黄娟,黄连红,等.血清mi R-137在中枢性性早熟女童中的临床检测意义[J].实用医学杂志,2016,32(15):2500-2503.
[19]朱廷富,邵华江.特发性中枢性性早熟与单纯性乳房早发育的鉴别诊断[J].中国性科学,2015,(9):49-52.
[20]戴晖,朱小琴,罗淑红,等.女童性早熟与环境内分泌干扰素的相关性研究[J].中国性科学,2017,26(6):58-60.
[21]Rodríguez Iglesias P,Gómez-Chacón Villalba J,Rodríguez Caraballo L,et al.Laparoscopic adrenalectomy:advantages of the minimally invasive approach[J].Cir Pediatr,2016,29(4):162-165.
[22]王雪梅,戴金星,王静.电化学发光法在性早熟女童血清雌二醇水平诊断的意义[J].检验医学与临床,2016,13(9):1261-1263.
[23]林翠兰,韦婉俭,何婉懿,等.促性腺激素释放激素类似物对特发性中枢性性早熟女童促生长素轴与生长速度的影响[J].中国儿童保健杂志,2016,24(1):65-68.
[2]谢理玲,杨玉,胡云,等.特发性中枢性性早熟女童干预治疗对体质量指数的影响[J].中华实用儿科临床杂志,2016,31(8):592-595.
[3]Ghanny BA,Malhotra S,Kumta S,et al.Should children with isolated premature adrenarche be routinely evaluated for non-classical congenital adrenal hyperplasia?[J].J Pediatr Endocrinol Metab,2016,29(3):351-356.
[4]中华医学会儿科学分会内分泌遗传代谢学组.中枢性性早熟诊断与治疗共识(2015)[J].中华儿科杂志,2015,53(6):412-418.
[5]李莉.血清IGF-1、IGFBP-3与生长激素治疗SGA矮小患儿的疗效[J].热带医学杂志,2016,16(4):493-495.
[6]徐焰,徐修礼,马越云,等.GHD矮小儿童血清IGF-1水平与血铅的相关性研究及其机制探讨[J].中华检验医学杂志,2015,38(4):238-242.
[7]程炳娟,刘戈力,李宁,等.特发性矮小生长激素受体外显子3基因多态性与生长激素轴的关系[J].天津医药,2016,44(1):78-82.
[8]Freire AV,Gryngarten MG,Ballerini MG,et al.Assessment of Estradiol Response after Depot Triptorelin Administration in Girls with Central Precocious Puberty[J].Horm Res Paediatr,2016,85(1):58-64.
[9]曾婷,李红辉,严提珍,等.柳州市特发性矮小症瑶族学龄儿童维生素D和IGF-1水平与体格发育指标的相关性分析[J].职业与健康,2017,33(6):794-796.
[10]赵艳琼,蔡秋玲,王鲁宁,等.广西汉壮瑶族儿童体能发育及其与IGF-1和IGFBP-3的相关性[J].中国学校卫生,2016,37(12):1763-1767.
[11]Sava觭s-Erdeve觭S,觭S覦klar Z,Hac覦hamdioglu B,et al.Gonadotropin-Releasing Hormone Analogue Treatment in Females with Moderately Early Puberty:No Effect on Final Height.[J].J Clin Res Pediatr Endocrinol,2016,8(2):211-117.
[12]金献江,罗越,吴慧平.促性腺激素释放激素类似物对特发性中枢性性早熟女童体质指数及骨代谢标志物水平的影响[J].中国全科医学,2016,19(9):1049-1052.
[13]周雪莲,傅君芬,金菊花,等.肥胖对中枢性性早熟女童Gn RH激发试验促黄体生成素峰值及相关激素的影响[J].中国当代儿科杂志,2015,17(8):763-768.
[14]吴慧平,金献江,罗越,等.骨代谢标志物在特发性中枢性性早熟女童血清中的变化及意义[J].浙江医学,2015,37(16):1347-1349.
[15]鱼建飞,马晓鹏,梅林华,等.特发性性早熟女童治疗前后血清性激素及IGF-1水平的研究[J].中国性科学,2017,26(4):81-84.
[16]Huguelet PS,Browner-Elhanan KJ,Fleming N,et al.Does the North American Society for Pediatric and Adolescent Gynecology Short Curriculum Increase Resident Knowledge in Pediatric and Adolescent Gynecology?[J].J Pediatr Adolesc Gynecol,2016,29(6):623-627.
[17]汪培欢,施弦.曲普瑞林对特发性中枢性性早熟女童治疗作用的自身前后对照观察[J].中国性科学,2016,25(3):59-62.
[18]唐家彦,黄娟,黄连红,等.血清mi R-137在中枢性性早熟女童中的临床检测意义[J].实用医学杂志,2016,32(15):2500-2503.
[19]朱廷富,邵华江.特发性中枢性性早熟与单纯性乳房早发育的鉴别诊断[J].中国性科学,2015,(9):49-52.
[20]戴晖,朱小琴,罗淑红,等.女童性早熟与环境内分泌干扰素的相关性研究[J].中国性科学,2017,26(6):58-60.
[21]Rodríguez Iglesias P,Gómez-Chacón Villalba J,Rodríguez Caraballo L,et al.Laparoscopic adrenalectomy:advantages of the minimally invasive approach[J].Cir Pediatr,2016,29(4):162-165.
[22]王雪梅,戴金星,王静.电化学发光法在性早熟女童血清雌二醇水平诊断的意义[J].检验医学与临床,2016,13(9):1261-1263.
[23]林翠兰,韦婉俭,何婉懿,等.促性腺激素释放激素类似物对特发性中枢性性早熟女童促生长素轴与生长速度的影响[J].中国儿童保健杂志,2016,24(1):65-68.