颅脑外伤对青少年与儿童生长激素的影响

摘要

目的：探讨颅脑外伤对青少年与儿童生长激素水平的影响。方法将80例青少年、儿童颅脑外伤患者分为儿童组27例、少年组32例、青春期组21例3个年龄组，分别在受伤后第1 d、第7 d、6个月时空腹检测血清生长激素（GH）、胰岛素样生长因子-1（IGF-1）水平，与正常同龄人进行比较。结果儿童组、少年组受伤后生长激素水平高于同龄正常值（均P＜0．05），青春期组受伤后生长激素水平低于同龄正常值（P＜0．05）。儿童组及少年组伤后生长激素第1 d升高，第7 d下降；青春期组伤后生长激素降低，第7 d逐渐升高。IGF-1受伤后均较同龄儿降低，随后逐渐升高。受伤6个月后78．7％的患者GH恢复正常，有21．2％的患者存在GH缺乏。结论颅脑外伤后对青少年、儿童患者GH及IGF-1水平产生明显影响，青春期及重型颅脑损伤患者影响最明显。尽早发现生长激素不足，并尽早干预可能改善其长期预后。%Objective To explore the influence on changes of growth hormone( GH) in children and teenagers suffered from traumatic brain injury ( TBI ) .Methods The serum GH levels in 80 patients were measured.Candidates were divided into children group(n=27),juvenile group(n=32) and teenagers group(n=21).The level of GH and Insulin-like Growth Factor-1(IGF-1) were tested at 1st, 7 th day and 6th month after the brain injury, the results were compared with the normal peers.Results After TBI, the GH level of children and juvenile group were higher than those in the normal peers(all P<0.05), the teenagers group was less than that in the normal peers (P<0.05).The GH level of children and juvenile group rised in the 1st day,and declined in the 7th day, and the teenagers group decline after TBI at once,then rised in the 7th day.The level of IGF-1 were less than the normal peers after traumatic brain injury,and rised gradually.The GH and IGF-1 level of 78.7%patients returned to normal after injury for six months,then 21.2%of patients had GH deficiency.Conclusions The traumatic brain injury have evident effect on children and teenagers in growth hormone, the teenagers and severe traumatic brain injury patients have a more obvious effect.Early detection of GH deficiecy and medication timely may improve the outcome.