【摘要】：目的： 目前認(rèn)為特發(fā)性矮�。╥diopathic short stature，ISS)可能是一種由多基因與環(huán)境等多因素共同作用而造成的疾病，暫時尚無明確原因。生長激素結(jié)合蛋白（growth hormone binding protein，GHBP）早已被發(fā)現(xiàn)與ISS的發(fā)生可能相關(guān)，但目前研究并不多。因此，本課題將從GHBP方面對ISS進(jìn)行研究，探討其與ISS的關(guān)系及臨床意義。 方法： 1、收集江西省兒童醫(yī)院內(nèi)分泌遺傳代謝科就診的矮小癥兒童235例。根據(jù)生長激素（growth hormone，GH）激發(fā)試驗(yàn)GH峰值＞10ng/ml、5～10ng/ml、＜5ng/ml，將矮小兒童分為特發(fā)性矮�。↖SS，115例）、部分生長激素缺乏（[partialgrowth hormone deficiency，pGHD），70例]及生長激素缺乏組[（growth hormonedeficiency，GHD），50例]。選擇115例ISS患兒為實(shí)驗(yàn)組，，健康體檢兒童45例作為正常對照組。 2、將ISS組與正常對照組GHBP水平進(jìn)行比較。 3、分析ISS組GHBP與GH峰值的關(guān)系。 4、比較34例使用GH治療并每3個月隨診的ISS患兒治療前、治療后3個月、治療后6個月血清GHBP水平。 5、采用酶聯(lián)免疫吸附試驗(yàn)(ELISA)測定血清GHBP水平，采用t檢驗(yàn)及直線回歸分析等統(tǒng)計學(xué)方法對結(jié)果進(jìn)行分析。 結(jié)果： 1、 ISS組血清GHBP水平高于正常對照組[(264.30±149.91)pmol/L vs(102.45±16.24)pmol/L，P＜0.05]。 2、ISS組血清GHBP水平與GH峰值無明顯相關(guān)性。 3、34例ISS患兒治療3個月后、治療6個月后與治療前相比，GHBP明顯下降（P＜0.05）。 結(jié)論： 1、ISS組與正常對照組之間血清GHBP水平有顯著差異，ISS組明顯高于對照組水平。GHBP可能與ISS的發(fā)生有關(guān)。 2、將ISS患兒GHBP與GH峰值進(jìn)行相關(guān)分析，結(jié)果顯示兩者之間無明顯相關(guān)性。正常人體GH的分泌存在晝夜節(jié)律性，但GHBP并無此節(jié)律性，這可能更有利于它對GH調(diào)節(jié)，維持血GH濃度達(dá)到穩(wěn)定。 3、ISS治療后GHBP水平較治療前明顯降低，且患兒身高標(biāo)準(zhǔn)差積分（heightstandard deviation score，HtSDS)較治療前有提高，提示GHBP可以作為ISS臨床療效的監(jiān)測指標(biāo)。
[Abstract]:Objective: it is thought that idiopathic dwarf (idiopathic short stature,ISS may be a disease caused by multiple factors such as polygene and environment. Growth hormone binding protein (growth hormone binding protein,GHBP) has long been found to be associated with the development of ISS, but there are few studies. Therefore, this paper will study ISS from the aspect of GHBP, and discuss the relationship between ISS and its clinical significance. Methods: 1. 235 cases of dwarf children in Department of Endocrinology and genetic Metabolism in Jiangxi Children's Hospital were collected. According to the peak value of GH > 10 ng / ml, < 5 ng / ml, the short children were divided into idiopathic dwarfs (ISS,115 cases), partial growth hormone deficiency (partialgrowth hormone deficiency,pGHD), according to the growth hormone (growth hormone,GH) stimulation test GH peak value > 10 ng / ml, < 5 ng / ml. There were 70 cases of growth hormone deficiency and 50 cases of growth hormone deficiency [(growth hormonedeficiency,GHD)]. 115 children with ISS were selected as experimental group and 45 healthy children as control group. 2. The level of GHBP in ISS group was compared with that in normal control group. 3. The relationship between GHBP and GH peak in ISS group was analyzed. 4. The serum GHBP levels of 34 ISS children who were treated with GH and followed up every 3 months were compared before, 3 months after treatment and 6 months after treatment. 5. The serum GHBP level was measured by Elisa (ELISA), and the results were analyzed by t test and linear regression analysis. Results: 1. The serum GHBP level in ISS group was higher than that in normal control group [(264.30 鹵149.91) pmol/L vs (102.45 鹵16.24) pmol/L,P < 0. 05]. 2 there was no significant correlation between the serum GHBP level and the peak value of GH. 3After 3 months of treatment, GHBP of 34 patients with ISS was significantly lower than that before treatment (P < 0. 05). Conclusion: 1 the serum GHBP level in ISS group was significantly higher than that in control group, and GHBP might be related to the occurrence of ISS. 2. The correlation analysis between GHBP and GH peak in children with ISS showed that there was no significant correlation between them. There is a circadian rhythm in the secretion of GH in normal human body, but there is no such rhythm in GHBP, which may be more favorable to the regulation of GH and maintain the stability of GH concentration in blood. 3The level of GHBP after treatment was significantly lower than that before treatment, and the height standard deviation score (heightstandard deviation score,HtSDS) of children was higher than that before treatment, suggesting that GHBP could be used as a monitoring index for the clinical efficacy of ISS.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R725.8

【引證文獻(xiàn)】

相關(guān)碩士學(xué)位論文 前1條

1 王倩;安徽省中小學(xué)生矮身材調(diào)查現(xiàn)況研究[D];安徽醫(yī)科大學(xué);2016年

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