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目的提高由于生长激素－胰岛素样生长因子（ＧＨ－ＩＧＦ）轴异常引起的生长发育迟缓诊断的准确性。方法分别收集门诊６８例生长发育迟缓儿童运动激发试验前后２次血清和１４例住院患儿药物激发试验１０次血标本，用免疫放射计量（ＩＲＭＡ）方法测定ＩＧＦ－１，ＩＧＦ－２和ＩＧＦＢＰ－３，放免方法（ＲＩＡ）测定ＧＨ。结果药物激发试验ＧＨ水平与ＩＧＦ－１，ＩＧＦ－２和ＩＧＦＢＰ－３测定一致。运动激发试验根据运动后ＧＨ水平及身高百分位的情况将６８例分为３组：ＧＨ＜５０μｇ／Ｌ，５０～１００μｇ／Ｌ，＞１００μｇ／Ｌ。ＧＨ＜５０μｇ／Ｌ组１４例，其中１０例身高小于第３百分位，其ＩＧＦ－１，ＩＧＦ－２和ＩＧＦＢＰ－３水平分别是（３９±２０），（２７４±１２２），（４２０±２１０）ｎｍｏｌ／Ｌ，低于正常值（Ｐ＜００１），ＧＨ水平与ＩＧＦ－１，ＩＧＦ－２和ＩＧＦＢＰ－３相符。结论用运动激发试验联合测定ＧＨ、ＩＧＦ－１和ＩＧＦＢＰ－３三项指标可以提高由于ＧＨ－ＩＧＦ轴异常所引起的生长发育迟缓诊断的准确性。
Objective To improve the accuracy of the diagnosis of growth retardation due to the abnormal growth hormone-insulin-like growth factor (GH-IGF) axis. Methods Blood samples were collected from 68 cases of growth retardation children before and after exercise challenge test and 14 cases of hospitalized children with drug challenge test. The levels of IGF-1, IGF-2 and IGFBP-2 were detected by immunoradioassay (IRMA) 3, radioimmunoassay (RIA) determination of GH. Results The level of GH in the drug challenge test was consistent with that of IGF-1, IGF-2 and IGFBP-3. According to exercise-induced GH level and height percentile, 68 cases were divided into 3 groups: GH <5 0μg / L, 5 0 ~ 10 0μg / L,> 10 0μg / L. 14 cases were GH <5 0μg / L group, of which 10 cases were less than the 3rd percentile, the levels of IGF-1, IGF-2 and IGFBP-3 were (39 ± 20) 4 ± 122), (420 ± 210) nmol / L, lower than the normal value (P <001), GH level was consistent with IGF-1, IGF-2 and IGFBP-3. Conclusion The combination of exercise-induced test with the three indicators of GH, IGF-1 and IGFBP-3 can improve the accuracy of diagnosis of growth retardation caused by GH-IGF axis abnormalities.