生长激素联合司坦唑醇治疗对Turner综合征女童成年身高的影响  

The major factors for improving final adult height in girls with Turner syndrome treated with recombinant human growth hormone and Stanazolol

作　　者：熊慧[1] 陈红珊[2] 杜敏联[2] 李燕虹[2] 马华梅[2] 苏喆[3] 陈秋莉[2] 古玉芬[2] 

机构地区：[1]中山大学附属第六医院儿科 [2]中山大学附属第一医院儿科,广州510080 [3]深圳市儿童医院内分泌科

出　　处：《中华实用儿科临床杂志》2015年第8期623-626,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：广东省高科技发展专项资金资助项目

摘　　要：目的 总结分析基因重组人生长激素（rhGH）联合小剂量司坦唑醇（ST）治疗对Turner综合征（TS）女童成年终身高（FAH）的影响.方法 回顾性分析1998年6月至2013年6月在中山大学附属第一医院儿科就诊的64例TS女童的FAH,其中38例接受联合治疗（治疗组）,26例未接受促生长治疗（未治疗组）.治疗组初治年龄（CA0）为（12.7±2.5）岁（6.8 ～18.4岁）、疗程为（2.8±1.3）年（0.6 ～5.5年）;结束治疗后随诊至最近一次测量的身高视为FAH;分析影响FAH的相关因素.结果 1.治疗组FAH改善了（7.9±5.0）cm,FAH明显高于未治疗组[（149.4±5.9）cm比（136.7±5.0） cm,t =9.001,P＜0.001].2.治疗组不同CA0各参数比较：10.0 ～11.9岁组、12.0 ～13.9岁组和14.0～15.9岁组平均疗程均达到2年,3组FAH比较差异无统计学意义（P＞0.05）.3.不同疗程各参数比较：疗程2.0～2.9年组、3.0 ～3.9年组和4.0 ～5.8年组平均FAH均达到健康女性人群身高-2s以内.4.治疗组相关性分析显示：FAH与遗传靶身高标准差分值（THtSDS）、初治时身高标准差分值（Ht0SDS）、rhGH＋ ST疗程和第1年生长速率呈正相关（r=0.464、0.753、0.532、0.428,P均＜0.01）,与CA0呈负相关（r=-0.466,P＜0.01）.逐步回归分析结果显示：Ht0SDS、rhGH＋ST疗程和THtSDS是影响FAH的独立因素（F=47.27、14.25、9.86,P均＜0.01）.结论 rhGH联合ST治疗能有效改善TS女童的FAH;对于CA0＜16岁TS女童,治疗2年FAH可能达到健康人群身高.初治时身高、rhGH＋ ST疗程及遗传靶身高影响FAH.Objective To analyze the major factors for improving final adult height （FAH） in girls with Turner syndrome （TS） treated with recombinant human growth hormone （rhGH） and Stanazolol（ST）.Methods The FAH of 64 girls with TS who were admitted into the First Affiliated Hospital of Sun Yat-Sen University from June 1998 to June 2013 were investigated.Among them,38 cases had received rhGH and ST for 0.6-5.5 years （treatment group）,their chronological age （CA0） was （12.7 ± 2.5） years （6.8-18.4 years）,and the course of the treatment was （2.8 ± 1.3） years（0.6-5.5 years） ;the other 26 girls without rhGH therapy were considered as the non-treatment group.The factors determining FAH were evaluated.Results （1） Compared with the non-treatment group,FAH in the treatment group was significantly higher[（149.4 ±5.9） cm vs （136.7 ±5.0） cm,t =9.001,P 〈0.001].The mean height gain was （7.9 ± 5.0） cm.（2） The subjects in the treatment group were divided into 5 age subgroups according to CA0：groups of the 6.0-7.9 years,10.0-11.9 years,12.0-13.9 years,14.0-15.9 years and 16.0-18.4 years group.For the 10.0-11.9 years,12.0-13.9 years and 14.0-15.9 years groups,they received rhGH ＋ST therapy for at least 2 years,and there was no significant difference in FAH among them （P 〉 0.05）.（3） Besides,the treatment group was then divided into 5 subgroups receiving different duration of therapy：the 0.6-0.9 years,1.0-1.9 years,2.0-2.9 years,3.0-3.9 years and 4.0-5.8 years group.The mean FAH of the 2.0-2.9 years,3.0-3.9 years and 4.0-5.8 years group was within normal height range of healthy Chinese female.（4） In treatment group,FAH was positively correlated with genetic target height SDS（THtSDS）,height SDS at the initiation of therapy （Ht0SDS）,the duration of rhGH ＋ ST therapy and growth velocity at the first year of treatment （r =0.464,0.753,0.532 and 0.428,all P 〈 0.01）,and was negatively correlated with CA0 （r =-0.466,P 〈 0.01）.Step wise regressi

关 键 词：Tuner综合征 人生长激素 重组 司坦唑醇 成年身高 影响因素 

分 类 号：R725.8[医药卫生—儿科]