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題名 | Insulin-like growth factor-I in prednisolone-treated children=接受prednisolone治療兒童的類胰島素生長第一因子(IGF-I)之研究 |
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作者 | 曹永魁; 李俊賢; 陳炯暉; | 書刊名 | 中華民國小兒科醫學會雜誌 |
卷期 | 31:1 民79.01-02 |
頁次 | 頁11-16 |
分類號 | 417.5 |
關鍵詞 | prednisolone; IGF-I; 兒童; 類胰島素生長第一因子; |
語文 | 英文(English) |
中文摘要 | 生長遲滯是接受長期prednisolone治療孩童常見的副作用之一,而生長激素是經由IGF-I刺激骨骼生長,爲了了解prednisolone治療對血漿IGF-I之影響,以11位接受prednisolone治療之兒童研究對象,於用藥前(或停藥後約1個月)及用藥至少10天後各抽血,以RIA方法定量IGF-I之濃度,抽血時prednisolone之劑量爲0.8-2.0mg/kg/day。結果發現沒有用prednisolone時之平均血漿IGF-I爲1.39±1.03u/ml,而使用prednisolone至少10天以上時爲2.95±1.16u/ml,此兩者呈有意義的差別(p<0.001)。此結果顯示prednisolone對生長的抑制不是經由減少IGF-I之製造;可能的解釋是prednisolone使得IGF-I對骨骼生長反應不佳或經由IGF-I抑制者的增加而達到抑制IGF-I活性的目的。如此,血液中IGF-I濃度的增加乃爲合理的代償作用。 |
英文摘要 | Impaired linear growth is a well-known side effect of long-term steroid therapy in children. To assess the steroid effects on plasma insulin-like growth factor 1 (IGF-I), 11 children with prednisolone treatment were evaluated for longitudinal study of IGF-l changes. The mean plasma IGF-I level without prednisolone use was 1.39±1.03 u/ml, while that on prednisolone therapy for a minimum of 10 days was 2.95±1.16 u/ml. A significant increase in plasma IGF-I concentrations was noted during long-term (more than 10 days) prednisolone therapy (P<0.001), but not found shortly after prednisolone administration. Our findings suggest that growth suppression of the steroid is not due to impaired IGF-I production, but rather, due to a defective IGF-I action either by end-organ unresponsiveness or via somatomedin inhibitors. |
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