目的:探讨血清胰岛素生长样因子-1(IGF-1)、维生素A、25-羟基维生素D(25-(OH D)水平在矮身材儿童中的临床价值。方法:选择我院2015年1月至2016年5月收治的146例矮身材儿童,同期选择109例身高正常的健康儿童作为对照组。比较所有研究对象的血清IGF-1、维生素A、25-(OH) D、身高水平,及治疗前后以上指标的改变,用受试者工作绘制特征(ROC)曲线分析指标预测价值。结果:矮身材儿童组血清IGF-1、维生素A、25-(OH) D、身高均低于对照组(P<0.05)。矮身材儿童治疗后血清IGF-1、维生素A、25-(OH) D及身高均高于治疗前(P<0.05)。血清IGF-1曲线下面积为0.722、敏感度及特异度分别为0.696和0.706,维生素A曲线下面积为0.712、敏感度及特异度分别为0.697和0.691,25-(OH) D曲线下面积为0.705、敏感度及特异度分别为0.913和0.411,联合检测曲线下面积为0.824、敏感度及特异度分别为0.783和0.794,联合检测曲线下面积明显高于单个指标。结论:血清IGF-1、维生素A及25-(OH) D可作为筛查和诊断矮身材儿童的有效指标,建议对矮身材儿童进行相应干预以改善成年终身高。
Objective: To explore the clinical value of serum insulin growth-like factor-1 (IGF-1),vitamin A and 25-hydroxyvitamin D (25- (OH) D) levels in short stature children. Methods: 146 cases of short stature children who treated from January 2015 to May 2015 in our hospital,at the same time 109 cases height of normal healthy children as control group. Then serum levels of IGF-1,vitamin A,25- (OH) D of all the subjects were compared,and the changes in the above indicators before and after treatment,the predictive value of ROC curve analysis indicators was obtained. Results: IGF-1,vitamin A,25- (OH) D and height in short stature children group were lower than those in the control group (P < 0.05). IGF-1,vitamin A,25- (OH) D and height in children with short stature after treatment were higher than before treatment (P<0.05).serum IGF-1 area under the curve was 0.722,sensitive and specific degree were 0.696 and 0.706,the area under the curve of vitamin A was 0.712,sensitive and specific degree were 0.697 and 0.691,the area under the curve of 25- (OH) D was 0.705,sensitive and specific degree were 0.913 and 0.411,the joint detection sensitivity and specific area under the curve was 0.824,the degree of 0.783 and 0.794,under the joint detection curve area significantly higher than that of single index. Conclusion: Serum IGF-1,vitamin A and 25- (OH) D can be used as effective indicators for the screening and diagnosis of children with short stature,Appropriate intervention is recommended for children with short stature,to improve adult life.