吴雪敏 林海丽 林晓 陈瑾

[摘要] 目的 分析抑制素B（INHB）、Makorin环指蛋白3（MKRN3）、成纤维生长因子受体2（FGFR2）对女童中枢性性早熟的预测价值。 方法 选取2018年1月至2021年1月期间于我院就诊中枢性性早熟女童100例作为中枢性性早熟组、健康体检的健康女童80名作为健康组。测定血清INHB水平、MKRN3、FGFR2相对表达量，比较三者在健康组、中枢性性早熟组中的表达及与疾病类型的关系，分析三者对此病的预测价值。结果 与健康组比较，中枢性性早熟组INHB水平升高，MKRN3、FGFR2相对表达量降低，差异有统计学意义（P<0.001）。进展型中枢性性早熟INHB水平高于缓慢进展型，MKRN3、FGFR2相对表达量低于缓慢进展型，差异有统计学意义（P<0.001）。Pearson相关性分析显示，INHB与MKRN3呈负相关（r=-0.420，P<0.001）;INHB与FGFR2呈负相关（r=-0.218，P=0.029）;MKRN3与FGFR2呈正相关（r=0.586，P<0.001）。与INHB、MKRN3、FGFR2单项预测比较，三项联合对女童中枢性性早熟的预测价值较高，差异有统计学意义（P<0.05）。 结论 中枢性性早熟女童血中INHB升高，MKRN3、FGFR2降低，且与疾病类型相关，三者联合对此病的预测价值较高。

[关键词] 抑制素B;Makorin环指蛋白3;成纤维生长因子受体2;女童中枢性性早熟

[中图分类号] R729          [文獻标识码] A          [文章编号] 1673-9701（2021）33-0023-04

[Abstract] Objective To analyze the predictive value of inhibin B （INHB）， makorin ring finger protein 3 （MKRN3）， and fibroblast growth factor receptor 2 （FGFR2） on central precocious puberty （CPP） of girls. Methods A total of 100 girls with CPP attending our hospital from January 2018 to January 2021 were selected as the CPP group and 80 healthy girls with health checkups as the healthy group. The relative expressions of serum INHB， MKRN3， and FGFR2 were measured， and the expressions of the three were compared between the healthy group and the CPP group. The correlation between the expressions of the three and the type of disease was analyzed， and the predictive value of the three for this disease was analyzed. Results Compared with the healthy group， the INHB level was increased and the relative expressions of MKRN3 and FGFR2 were decreased in the CPP group， with statistically significant differences（P<0.001）. The INHB level in progressive CPP was higher than that in slowly progressive CPP， and the relative expressions of MKRN3 and FGFR2 in progressive CPP were lower than those in slowly progressive CPP， with statistically significant differences（P<0.001）. Pearson correlation analysis showed that there was a negative correlation between INHB and MKRN3 （r=-0.420， P<0.001）， and between INHB and FGFR2 （r=-0.218， P=0.029）， and there was a positive correlation between MKRN3 and FGFR2（r=0.586， P<0.001）. Compared with INHB， MKRN3， and FGFR2 alone， the combination of the three had a higher predictive value for CPP of girls， with statistically significant difference（P<0.05）. Conclusion The increase of INHB level and the decrease in relative expressions of MKRN3 and FGFR2 in the blood of girls with CPP are correlated with the type of disease， and the combination of the three can achieve a higher predictive value for this disease.

[Key words] Inhibin B; Makorin ring finger protein 3; Fibroblast growth factor receptor 2;Central precocious puberty of girls

中枢性性早熟属小儿内分泌疾病，女童发病率明显高于男童，研究认为，此病的发生可影响着患儿的正常发育[1-2]。因此早期的诊治对此病的治疗和预后具有重要的意义，目前临床上对于此病的預测较为困难，且相关报道较少，因此寻找特异性预测此病的指标具有重要的意义。抑制素B（Inhibin B，INHB）属于卵巢的直接产物，其在围青春期中的水平变化可反映卵泡活性，可用于女性青春期进展的评估[3]。研究显示[4]，下丘脑-垂体-性腺轴活化可促进性早熟的发生，而此轴活化受到多种基因的调控，其中以Makorin环指蛋白3（Makorin ring finger protein 3，MKRN3）研究最为广泛，研究认为此基因与性早熟相关。成纤维生长因子受体2（Fibroblast growth factor receptor 2，FGFR2）与骨骼发育相关，而骨骼发育异常为性早熟的表现之一，推测其可能与性早熟有关[5]。鉴于上述研究背景，在本研究中分析INHB、MKRN3、FGFR2在女童中枢性性早熟中的表达情况，并研究三者对此病的预测价值，以早期预测此病，促进患儿正常发育，现报道如下。……