| Objective: The insulin-like growth factors-1(IGF-1)belongs to one of the members of the insulin hormone family,is a kind of polypeptideprotein substance similar to insulin in molecular structure.IGF-1 plays important roles in regulating growth,development and metabolism of humans and animals.IGF-1 acts as a growth factor through conjugating specific receptors and protein.IGF-1 have extensive physiological functions,which can promote cell proliferation and adjust organism development and affect substance metabolism.Furthermore they can directly or indirectly regulate skeleton growth.Growth-Promoting actions of growth hormone(GH)were mediated by IGF-1.The purpose of this study is to evaluate the changes of IGF-1,insulin-like growth factor binding protein-3(IGFBP-3)and the cardiac function before and after interventional therapy,to investgate whether the changes of IGF-1 and IGFBP-3 can effectively reflect the change of ventricular septal defect(VSD)after interventional therapy in the heart function and cardiac structure.Methods: We studied 30 children with VSD in the First Hospital of Hebei Medical University from September 2015 to March 2016,who received interventional therapy successfully.Their ages range from 2 to 8,average of4.40±1.92.Blood specimens from children with VSD were collected at the following time points: before the interventional therapy,and in the 1st week,1st month,3rd month,the 6th month and the 12 th month after the interventional therapy.IGF-1 and IGFBP-3 were measured by immunoradiometric assay.Evaluation of cardiac function indicators include the diameter of right ventricular(RV),right atrium(RA),left atrium(LA),leftventricle end-diastolic diameter(LVEDD),left ventricle end-systolic diam-eter(LVESD),left ventricle end-diastolic volume(LVEDV),left ventricle end-systolic volume(LVESV),stroke volume(SV)and ejection fraction(EF).The children were observed in terms of heart rate,blood pressure,heart murmur,the existence of arrhythmia,etc before interventional therapy,and in 1st week,1st month,3rd month,the 6th month after the interventional therapy.The statistics were processed and analyzed by the SPSS 22.0.Results:1 Clinical baseline characteristics of the subjects: There were no difference in terms of age,height,sex and weight between the two groups;2 The change of plasma IGF-1 level: The plasma level of IGF-1 was lower in VSD group(P< 0.01)as compared with the normal control subjects,and elevated gradually after the interventional therapy.After one week of the operation,the plasma IGF-1 level increased obviously but still lower than the normal group.The plasma level of IGF-1 continued to increase slowly in the following months until one year after the operation they reach the normal standard and there was no significant difference between the two groups in the first year after interventional therapy(P >0.05);The change of plasma IGFBP-3 level: The plasma level of IGFBP-3 was lower in VSD group(P<0.01)as compared with the normal control subjects,and elevated gradually after the interventional therapy.After one week of the interventional therapy,the plasma IGFBP-3 level increased obviously but still lower than the normal group.The plasma level of IGFBP-3 continued to increase slowly in the following months until one year after the interventional therapy they reach the normal standard and there was no significant difference between the two groups in the first year after interventional therapy(P > 0.05);3 The changes of atrioventricular structure and cardiac function in VSD patients: LVEDD,LVESD,LVEDV,LVESV,SV reduced after interventional therapy,which decreased significantly in the sixth month after interventional therapy,but there were no significant differences of RV,RA,LA and EF after interventional therapy;4 There were no significant change of vital sign in all of the children who have VSD after interventional therapy.The degree of heart murmur significantly reduced or disappeared.Three children had arrhythmia in a short time during the interventional therapy and all of them recovered.There was no death in the research.5 The relation between the levels of IGF-1 IGFBP-3 and cardiac structure and function: The levels of IGF-1,IGFBP-3 were correlated with RV,LVEDD,LVEDV,LVESV,SV.But there was no correlation with the levels of IGF-1,IGFBP-3 and RA,EF,LA,LVESD.Conclusions:1 Our result suggest that was of the change of the levels of IGF-1 and IGFBP-3 in children with VSD.Interventional therapy could alleviate those.2 The level changes of IGF-1 and IGFBP-3 reflected indirectly the change of the cardiac volume overload and size of atrioventricular cavity.The level of IGF-1 and IGFBP-3 is probably an important criteria of evaluating the change of cardiac function. |
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