作　　者： (武苏）; (刘倩琦）; (顾威）; (倪世宁）; (石星）; (朱子阳）;

机构地区： 南京医科大学附属儿童医院,南京210008

出　　处： 《基因组学与应用生物学》 2017年第8期3322-3327,共6页

摘　　要： 采用临床对照研究来探究身材矮小儿童青春期激素水平及体重指数的相关性。本研究选取身材矮小患儿208例,男性122例(10~14岁),女性86例(8~13岁),其中进入青春期(TannerⅡ~Ⅳ期)的发育组患儿104例,对照组为年龄性别匹配的未发育组患儿104例。所有患儿由内分泌专科医师进行体检,行空腹行精氨酸-可乐定生长激素激发试验;完善甲状腺功能、生化、IGF1、胰岛素、C肽、血糖测定及左手骨龄片检查。结果表明患儿在青春期的IGF1、胰岛素、C肽及血糖浓度均有统计学意义,而生长激发试验、骨龄增高以及甲状腺功能无统计学意义,说明身材矮小患儿青春期GH-IGF1轴反应受损;虽然发育组较未发育组有身高的增长,但仍明显低于正常;最终发现进行完善的体检和实验室检查,特别是IGF1、胰岛素、C肽及血糖等指标利于早期发现不同病因矮小患者,提高诊断治疗水平。 Clinical controlled study was used in order to explore the correlation between the hormone levels and body mass index in pubertal children with short stature. In this study, 208 children with short stature were selected as sample, including 122 males （10-14 years） and 86 females （8-13 years）. There were 104 cases in pubertal group （Tanner stage Ⅱ -Ⅳ）, while there were 104 cases in prepubertal group （Tanner stage Ⅰ ） with age and sex matched. All patients received the clinical evaluation of height, weight and pubertal stage by pediatric endocrinologists. All of those patients underwent GH stimulation testing after overnight fast, with a combination of arginine and clonidine. And blood biochemistry, thyroid function, insulin, C-peptide, insulin-like growth factor 1 （IGF1） and bone age were also measured. The results showed that insulin in adolescence, IGF1, blood glucose and C peptide concentrations of the patients were statistically significant, while the growth stimulating test, increased bone age and thyroid function was not statistically significant, indicating that adolescent GH-IGF1 axis reaction of pubertal children with short stature was damaged. Although there was an increase in height in the pubertal group than in the prepubertal group, it was still lower than the normal. It was found that the perfect physical examination and laboratory examination, especially on IGF1, insulin, C peptide and blood glucose were helpful for the early detection of patients with different causes of short stature, and could improve the level of diagnosis and treatment.

关 键 词： 身材矮小 青春期 激素 体重指数