【摘要】 目的探讨1~4岁脑瘫患儿血清生长激素(GH)、胰岛素样生长因子-1(IGF-1)水平与身心发育的相关性.方法选取1~4岁脑瘫患儿142例,按体格发育情况分为脑瘫伴发育迟缓组(Cp-R)100例、脑瘫发育正常组(Cp-N)42例;按粗大运动功能分类系统分为运动功能轻度障碍Ⅰ~Ⅱ级组(Cp-GⅠ~Ⅱ)40例、中重度障碍Ⅲ~Ⅴ级组(Cp-GⅢ~Ⅴ)102例;根据美国婴幼儿发展评估量表-Ⅲ中的智力发育评估指数分为脑瘫伴智力低下组112例、脑瘫不伴智力低下组30例,选取同期健康体检的同年龄段儿童30例为对照组.检测各组儿童GH、IGF-1、胰岛素样生长因子结合蛋白-3水平.结果 Cp-R组GH峰值和IGF-1均明显低于Cp-N组,差异具有统计学意义(P<0.05);Cp-N组和Cp-R组GH峰值、IGF-1均明显低于对照组,差异具有统计学意义(P<0.05).GH基础值和胰岛素样生长因子结合蛋白-3在各组间差异无统计学意义(P>0.05).Cp-GⅢ~Ⅴ组GH峰值、IGF-1值均明显低于Cp-GⅠ~Ⅱ组,差异具有统计学意义(P<0.05);Cp-GⅢ~Ⅴ组和Cp-GⅢ~Ⅴ组GH峰值、IGF-1值均明显低于对照组,差异具有统计学意义(P<0.05).脑瘫伴智力低下组IGF-1值明显低于脑瘫不伴智力低下组和对照组,差异具有统计学意义(P<0.05);脑瘫伴智力低下组和脑瘫不伴智力低下组GH峰值明显低于对照组,差异具有统计学意义(P<0.05).结论 GH,IGF-1水平低下会导致脑瘫患儿运动伴认知功能发育迟缓,GH/IGF-1轴受损是其可能机制.更多还原

【Abstract】 Objective To investigate the relationship between serum GH,IGF-1 levels and physical and mental development in children aged 1 ~ 4 years old with cerebral palsy. Method A total of 142 cases of 1 ~ 4 years old children with cerebral palsy were divided into 100 cases of retardate cerebral palsy group( Cp-R) and 42 cases of cerebral palsy normal group( Cp-N) according to their development situation of physique. According to the gross motor function classification system,the patients were divided into motion function disorder mild grade Ⅰ-Ⅱgroup( Cp-G Ⅰ ~ Ⅱ) with 40 patients,and moderate to severe disabilities Ⅲ ~ Ⅴgrade group( Cp-G Ⅲ ~ Ⅴ)with 102 cases. According to the intellectual development assessment index of the American infant assessment scale Ⅲ,the children were divided into 112 cases of cerebral palsy with mental retardation group and 30 cases of cerebral palsy without mental retardation group. At the same period,30 children of the same age were selected as the control group. The levels of GH,IGF-1 and insulin-like growth factor binding protein-3 in the children were detected. Results The peak value of GH and IGF-1 in group Cp-R were significantly lower than those in groupCp-N( P<0. 05),and the peak value of GH and IGF-1 in group Cp-N and group Cp-R were significantly lower than those in the control group( P<0. 05). There was no significant difference in GH basic value and insulin-like growth factor binding protein-3 among the groups( P >0. 05). GH and IGF-1 peak values of Cp-G Ⅲ ~ Ⅴ group were significantly lower than those of Cp-GⅠ~Ⅱgroup( P<0. 05),and GH and IGF-1 peak values of Cp-G Ⅲ ~ Ⅴgroup and Cp-G Ⅲ ~ Ⅴ group were significantly lower than those of the control group( P<0. 05). IGF-1 value of the cerebral palsy with mental retardation in group was significantly lower than that of the cerebral palsy without mental retardation group and the control group( P<0. 05). GH peak values of the cerebral palsy groups were significantly lower than that of the control group( P<0. 05). Conclusion Low levels of GH and IGF-1 may lead to motor and cognitive function retardation in children with cerebral palsy,and GH/IGF-1 axis damage is the possible mechanism.更多还原