生长激素治疗Turner综合征患儿糖脂代谢临床观察  

Clinical observation on glucose and lipid metabolism in Turner syndrome children with growth hormone treatment.

作　　者：刘应科[1] 张知新[1] 赵秋玲[1] 苏慧敏[1] 张琼[1] 

机构地区：[1]卫生部中日友好医院儿科,北京100029

出　　处：《中国实用儿科杂志》2011年第5期373-376,381,共5页Chinese Journal of Practical Pediatrics

摘　　要：目的通过观察Turner综合征(TS)患儿使用重组人生长激素(rhGH)后糖、脂质代谢的变化,为其安全性治疗提供临床数据。方法对2007年7月至2010年6月在卫生部中日友好医院明确诊断为TS的28例患儿进行体脂、血脂检测,葡萄糖耐量试验(OGTT),采用rhGH替代治疗6个月后复查上述指标,比较治疗前后糖、脂代谢指标的变化。结果在28例患儿中发现单体型、嵌合体型、X染色体长臂等臂型、X染色体长臂缺失型4类异常的染色体核型;体脂测量中,体脂含量(FAT%)治疗前后差异有统计学意义(P<0.05),脂肪重量(FM)治疗前后差异无统计学意义(P>0.05);血脂检测中,血清高密度脂蛋白(HDL-C)、低密度脂蛋白(LDH-C)治疗前后差异有统计学意义(P<0.05);血清甘油三酯(TG)、胆固醇(CHO)治疗前后差异无统计学意义,治疗前TG异常5例,CHO异常6例,治疗后均变为2例异常。在OGTT试验中,5例患儿存在糖耐量减低(IGT),治疗后IGT例数无改变,胰岛素抵抗指数(HOMA-IR)治疗前后(1.63±0.45对1.58±0.44)差异无统计学意义。结论 TS患儿存在糖、脂质代谢紊乱的高风险,通过rhGH治疗后,脂代谢紊乱得到改善,糖代谢紊乱无加重,临床上有必要对TS的患儿监测糖脂代谢的指标。Objective To observe the glucose and lipid metabolism changes after recombinant human growth hormone treatment in the Turner syndrome patients,and provide safety data for clinical therapy.Methods Twenty-eight Turner syndrome children were selected who were definitely diagnosed with Turner syndrome between July 2007 and June 2010 in China-Japan Friendship Hospital.Each took the body fat checking,lipid level detection and glucose tolerance test before and after 6 months of rhGH therapy.The human growth hormone was given through subcutaneous injection.Use the two paired t-test to compare the data before and after the treatment in glucose and lipid metabolism.Results There were 4 abnormal karyotypes in the 28 cases.In the measurement of body fat,there were significant differences （P 〈0.05） in the fat percentage,but no significant differences （P〉0.05） in the fat mass.In the lipid level detection,there were significant differences （P〈0.05） in HDL-C and LDL-C after GH intervention.The TG and CHO improved a little,but there were no significant differences （P〉0.05） between before and after the treatment.In the OGTT test,5 IGT cases were founded.This situation was not changed after 6 months of treatment.There was no significant difference in the HOMA-IR （1.63±0.45 vs 1.58±0.44） during the GH intervention.Conclusion There is a high risk of glucose and lipid metabolism disorder in the TS children.After 6 months of recombinant human growth hormone intervention,the lipid metabolism can be improved,and the glucose metabolism can be aggravated.It is necessary to monitor the patient＇s glucose and lipid metabolism further.

关 键 词：TURNER综合征 生长激素 葡萄糖代谢 脂质代谢 

分 类 号：R72[医药卫生—儿科]