摘要
目的观察基因重组人生长激素(recombinant human growth hormone,rhGH)治疗矮小症患儿的疗效和安全性,分析治疗中的综合管理。方法收集2016-2018年锦州医科大学附属第一医院矮小症儿童63例,平均年龄9岁。根据病因分为2组:生长激素缺乏症(growth hormone deficiency,GHD)组(n=37,rhGH剂量为每日0.12~0.15 IU/kg),特发性身材矮小(idiopathic short stature,ISS)组(n=28,rhGH剂量为每日0.15 IU/kg)。两组同时辅助综合管理(饮食与营养指导、合理运动、高质量的睡眠、生理-心理的影响)及口服维生素D 3400 IU/d。比较治疗后3个月、6个月、9个月及12个月时生长速率(height velocity,HV)、身高标准差积分(height standard deviation score,HtSDS)、血清胰岛素样生长因子-1(insulin-like growth factor-1,IGF-1)、骨龄(bone age,BA)、实际年龄(chronological age,CA)、身高年龄(height age,HA)及空腹血糖(fasting blood glucose,FBG)等指标变化。结果两组治疗后HtSDS及HV均有提高,GHD组治疗后6个月、9个月及12个月时HtSDS及HV均高于ISS组(P<0.05)。两组治疗后血清IGF-1水平均提高,且血清IGF-1水平与HtSDS呈正相关。两组治疗1年骨龄的进展差异无统计学意义(P>0.05)。ISS组出现1例头疼,每组各有1例出现一过性空腹血糖轻微升高(均为6.1 mmol/L)。结论rhGH促进矮小症儿童生长的效果确切,不良反应少,接受治疗的GHD儿童身高增长速度优于ISS儿童。配合良好的综合管理,同时培养孩子健康的生活习惯,可以使药效得到更好发挥。
Objective To assess the effect and safety of recombinant human growth hormone(rhGH)in treatment of short stature children and discuss the comprehensive management during treatment.Methods A total of 63 short stature patients with average age of 9 years were enrolled in this study from 2016 to 2018 in the first affiliated hospital of Jinzhou Medical University.According to the etiology,they were divided into growth hormone deficiency(GHD)group(rhGH,0.12-0.15 IU/kg daily)and idiopathic short stature(ISS)group(rhGH,0.15 IU/kg daily).Comprehensive management(diet and nutrition guidance,exercise,high-quality sleep,etc.)was performed to assist treatment and vitamin D3 was administrated orally for 400 IU per day.The changes in height velocity(HV),height standard deviation score(HtSDS),serum levels of insulin-like growth factor-1(IGF-1),bone age(BA),chronological age(CA),height age(HA)and fasting blood glucose(FBG)at 3,6,9 and 12 months after treatment were compared between the two groups.Results HtSDS and HV both increased after the treatment in the two groups,and they were significantly higher in the GHD group than those in the ISS group at 6,9 and 12 months after treatment(P<0.05).The serum level of IGF-1 increased in the two groups after treatment,and it was positively correlated with HtSDS.There was no statistically significant difference in bone age at 1 year after treatment between the two groups(P>0.05).One case had headache in ISS group.Transient slight increase of fasting blood glucose(6.1 mmol/L)was observed in 1 case in each group.Conclusion rhGH is effective in treatment of short stature children with few adverse events.The growth rate in GHD patient is superior to ISS.Good comprehensive management and cultivation of children’s healthy living habits are helpful and necessary.
作者
康宁宁
李静
吴荣荣
孙丽
乐原
KANG Ningning;LI Jing;WU Rongrong;SUN Li;LE Yuan(Department of Pediatrics,the First Affiliated Hospital of Jinzhou Medical University,Jinzhou 121000,Liaoning Province,China)
出处
《解放军医学院学报》
CAS
2019年第10期931-936,共6页
Academic Journal of Chinese PLA Medical School
基金
辽宁省大学生创新创业课题(201710160000193)~~
关键词
重组人生长激素
生长激素缺乏症
特发性身材矮小
生长速率
儿童
recombinant human growth hormone
growth hormone deficiency
idiopathic short stature
growth rate
child
