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吴至凤,赵聪敏,廖伟,张雨平,王丽雁,何菲,冯雪菲,李胤颖,余秀梅.生长激素/胰岛素样生长因子-1轴与脑瘫儿童认知、大运动功能的关系[J].陆军军医大学学报(原第三军医大学学报),2016,38(08):863-867.
Wu Zhifeng,Zhao Congmin,Liao Wei,Zhang Yuping,Wang Liyan,He Fei,Feng Xuefei,Li Yinying,Yu Xiumei.Relationship of GH/IGF-1 axis with gross motor and cognitive development in cerebral palsy toddlers[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(08):863-867.
吴至凤,赵聪敏,廖伟,张雨平,王丽雁,何菲,冯雪菲,李胤颖,余秀梅.生长激素/胰岛素样生长因子-1轴与脑瘫儿童认知、大运动功能的关系[J].陆军军医大学学报(原第三军医大学学报),2016,38(08):863-867. DOI:
Wu Zhifeng,Zhao Congmin,Liao Wei,Zhang Yuping,Wang Liyan,He Fei,Feng Xuefei,Li Yinying,Yu Xiumei.Relationship of GH/IGF-1 axis with gross motor and cognitive development in cerebral palsy toddlers[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(08):863-867. DOI:
目的 评估GH/IGF-1轴与幼龄脑瘫儿童粗大运动功能与认知发育的关系。 方法 纳入2012年1月至2014年12月新桥医院儿科住院的1~4岁脑瘫儿童71例作为脑瘫组,按体格发育落后与否划分为脑瘫伴发育迟滞组(cerebral palsy with retardation,CP-R)50例及脑瘫发育正常组(cerebral palsy with normal growth,CP-N)21例;按粗大运动功能分类系统(gross motor function classification system,GMFCS)划分为Ⅰ~Ⅱ级组20例(CP-GMFCS Ⅰ~Ⅱ),Ⅲ~Ⅴ级组51例(CP-GMFCS Ⅲ~Ⅴ);按Bayley评分划分智力发育指数(mental development index,MDI)≥70组15例(CP-MDI≥70),MDI70组56例(CP-MDI70)。健康对照组为同期体检的健康儿童15例。观察上述儿童的血浆GH基础值及激发值、胰岛素样生长因子-1(insulin-like growth factorⅠ
IGF-1)、类胰岛素生长因子结合蛋白3(insulin-like growth factor-binding protein 3,IGFBP-3)水平作对照研究。 结果 ①CP-R组较CP-N组GH峰值显著降低,上述2组均较健康对照组GH峰值和IGF-1值显著降低(P0.05)。②CP-GMFCS Ⅰ~Ⅱ组和CP-GMFCS Ⅲ~Ⅴ组较健康对照组GH峰值和IGF-1值显著降低,CP-GMFCS Ⅲ~Ⅴ组较CP-GMFCS Ⅰ~Ⅱ组GH峰值和IGF-1值显著降低(P0.05)。③CP-MDI70组和CP-MDI≥70组较健康对照组GH峰值显著降低(P0.05);CP-MDI70组较CP-MDI≥70组和健康对照组IGF-1值显著降低(P0.05)。 结论 脑瘫伴体格发育迟缓、重度粗大运动功能障碍及明显MDI指数落后的儿童存在GH/IGF-1轴受损,提示GH、IGF-1低下可能是脑瘫儿童运动伴认知水平低下的原因之一。
Objective To evaluate the relationship of the growth hormone/insulin-like growth factor-l (GH/IGF-1) axis with gross motor and cognitive development in cerebral palsy (CP) toddlers. Methods A total of 86 toddlers
who suffered from CP(n=71) or were normal (n=15) from 1 to 4 years old
were divided into control group and CP group. The CP group was further divided into CP with retardation group (CP-R group
n=50) and CP with normal growth group (CP-N group
n=21 toddlers). According to the gross motor function classification system (GMFCS)
the CP group were also designated into CP-GMFCS Ⅰ~Ⅱ group (n=20) and CP-GMFCS Ⅲ~Ⅴ group (n=51). According to Bayley scores
the CP was designated into mental development index (MDI)≥70 group (CP-MDI≥70 group
n=15) and MDI70 group (CP-MDI70 group
n=56). The base value and peak value of plasma GH
and the levels of IGF-1 and insulin-like growth factor-binding protein 3 (IGFBP-3) were analyzed. Results The GH peak value of CP-R group was lower than that of CP-N group
and both GH peak value and IGF-1 level of the 2 groups were lower than those of the control group (P0.05). CP-GMFCS Ⅰ~Ⅱ group and CP-GMFCS Ⅲ~Ⅴ group showed lower GH peak value and IGF-1 level than the control group
and CP-GMFCS Ⅲ~Ⅴ group showed lower GH peak value and IGF-1 level than CP-GMFCS Ⅰ~Ⅱ group (P0.05). CP-MDI70 group and CP-MDI≥70 group showed lower GH peak value than control group (P0.05)
and CP-MDI70 group showed lower IGF-1 level than CP-MDI≥70 group and control group (P0.05). Conclusion The GH/IGF-1 axis damage exists in the toddlers with CP with retardation
gross motor function disorder and obviously low MDI
which predicts that low GH and IGF-1 levels may be one of the factors causing laggardly motor and cognition in CP toddlers.
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