摘要
目的探讨低剂量基因重组人生长激素(rhGH)治疗颅咽管瘤术后生长激素缺乏症(GHD)患儿的疗效和安全性。方法回顾性分析2008年4月-2011年4月在北京三博脑科医院内分泌门诊治疗的12例7～15岁术后病理确诊为颅咽管瘤且继发生长迟滞患儿的病例资料及随访资料。患儿均给予rhGH治疗(每晚睡前皮下注射0.1 IU.kg-1,每周5次注射),疗程3～36个月。定期检测肝功能、肾功能、激素水平等指标,并比较患儿治疗前后身高、体质量、生长速度、身高标准差计数、胰岛素样生长因子1(IGF-1)、骨龄等生长指标的改变。结果在rhGH治疗期间,12例患儿在治疗第1年生长速率增加显著,由(2.2±1.3)cm.a-1增加到(6.63±4.97)cm.a-1(P<0.01),身高标准差计数由治疗前-3.3±2.3增加到-3.2±2.8,血IGF-1治疗前为(38±64)μg.L-1,治疗后为(173±167)μg.L-1(患儿治疗后血清IGF-1水平达到正常范围),差异均有统计学意义(Pa<0.01)。治疗期间,患儿肝肾功能等均保持在正常值范围,骨龄无明显变化,随访时尚无患儿肿瘤复发。结论低剂量rhGH治疗儿童颅咽管瘤术后继发GHD是经济、有效的,在充分评估及严密监控下开展GH替代治疗是安全的。
Objective To discuss the effectiveness and safety of recombinant human growth hormone（rhGH） replacement treatment in growth hormone deficiency（GHD） children with craniopharyngioma after surgical treatment. Methods This study retrospectively reviewed the records of 12 outpatients with secondary GHD who were treated with rhGH at Department of Neuroendocrinology,Beijing Sanbo Brain Hospital from Apr.2008 to Apr.2011.All children（aged 7-15 years） were pathologically diagnosed as craniopharyngioma after surgery,and their follow-up data were included in this analysis.All of the 12 children were given rhGH via subcutaneous injection daily in every evening in original dose of 0.1 IU·kg-1,5 days per week,and the course of treatment ranged from 3 to 36 months.Biochemical tests,including liver function,kidney function and plasma hormones concentrations,were arranged regularly.Data of height,weight,growth velocity,standard deviation scoring（SDS）,serum insulin-like growth factor 1（IGF-1）,bone age were recorded and compared before and after the rhGH treatment. Results After one year rhGH replacement therapy,the growth velocities of 12 patients were significantly increased from（2.2±1.3） cm·a-1 to（6.63±4.97） cm·a-1（P0.01）,SDS had changed from-3.3±2.3 to-3.2± 2.8（P0.01）,and IGF-1 concentrations were increased from（38±64） μg·L-1 to（173±167） μg·L-1（reaching the normal range）（P0.01）.During the treatment,biochemical tests were in normal range,and there was no speed-up development in the bone age.No tumor recurrence was found by the time of following-up. Conclusions The low dose GH replacement therapy is effective and financially economical in secondary GHD children with craniopharyngioma after surgical treatment.Evaluating and monitoring the states of patients′ condition before and during rhGH therapy is necessary to ensure the safety of treatment.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2012年第8期634-636,共3页
Journal of Applied Clinical Pediatrics
关键词
颅咽管瘤
生长激素缺乏
替代治疗
儿童
craniopharyngioma
growth hormone deficiency
replacement therapy
child
