重组人生长激素治疗3类青春期前矮小患儿的疗效分析  

Clinical effect of recombinant human growth hormone on treatment of three kinds of short stature before puberty in children

作　　者：梁晓红[1] 

机构地区：[1]珠海市妇幼保健院儿童保健科,广东珠海519000

出　　处：《中国妇幼健康研究》2015年第2期258-261,共4页Chinese Journal of Woman and Child Health Research

摘　　要：目的观察青春期前生长激素缺乏症(GHD)、小于胎龄儿(SGA)、特发性矮小(ISS)3类矮小患儿用重组人生长激素(rhGH)规范化治疗6个月的疗效及不良事件发生率。方法选取在珠海市妇幼保健院诊断,用rhGH规范化治疗达6个月的41例矮小患儿,分GHD、SGA、ISS 3组,比较患儿治疗前、后身高(Ht)、身高标准差积分(HtSDS)、生长速率(HV),体质量指数(BMI)、血清胰岛素样生长因子1(IGF1)的变化,并记录不良事件。结果 GHD、SGA、ISS组治疗6个月的Ht分别较治疗前增加了5.6±0.8cm、4.9±0.8cm、5.0±0.6cm,治疗前后差异均有统计学意义(t值分别为-29.38、-17.79、-29.93,均P<0.01);HtSDS分别较治疗前增加了0.58±0.17s、0.52±0.16s、0.42±0.09s,治疗前后差异均有统计学意义(t值分别为-14.62、-9.13、-1.764,均P<0.01);HV分别较治疗前提高了6.9±2.2cm/年、4.8±1.6cm/年、4.4±1.5cm/年,治疗前后差异均有统计学意义(t值分别为-13.81、-8.34、-10.94,均P<0.01)。3组患儿用rhGH治疗6个月均有较满意疗效。治疗后身高差值(△Ht)、身高标准差积分差值(△HtSDS)、生长速率差值(△HV)比较,均是GHD组改变最大,而GHD组rhGH治疗剂量为3组最低(F值分别为4.425、4.797、7.994,均P<0.05),说明GHD儿rhGH治疗投入效益比最好。3组患儿治疗前后BMI差值(△BMI)、血IGF1差值(△IGF1)无显著性改变(均P>0.05)。总不良事件发生率为7.3%(3/41),均为实验室检查指标轻微异常。结论 rhGH规范化治疗青春期前GHD、SGA、ISS儿均安全有效,尤以GHD治疗效果最好。因此,应加强健康教育,增进患儿及家长的治疗信心,加强矮小儿童早治疗、足剂量、长疗程管理。Objective To observe the efficacy of 6-month standardized treatment with recombinant human growth hormone （rhGH） on children who have a short stature suffering from growth hormone deficiency （GHD）, small for gestational age （SGA） or idiopathic short statues （ ISS） and analyze the incidence of adverse events after treatment.Methods Forty-one children with short stature accepting 6-month treatment of rhGH in Zhuhai Maternal and Child Health Hospital were involved in this study and were assigned into 3 groups, GHD group, SGA group and ISS group.The changes in height （Ht）, height standard deviation score （HtSDS）, height velocity （HV）, body mass index （BMI）, insulin-like growth factors-1 （IGF1） were compared before and after treatment, and all the corresponding adverse events were recorded.Results Compared with those before treatment, Ht increased by 5.6 ±0.8cm, 4.9 ±0.8cm and 5.0 0.6cm, respectively after treatment with significant differences （t value was -29.38, -17.79 and -29.93, respectively, all P〈0.01）, HtSDS increased by 0.58 ±0.17s, 0.52 ±0.16s and 0.42 ±0.09s, respectively after treatment with significant differences （t value was -14.62, -9.13 and-1.764, respectively, all P〈0.01）, and HV increased by 6.9 2.2cm/year, 4.8 1.6cm/year and 4.4 1.5cm/year, respectively with significant differences （t value was -13.81, -8.34 and -10.94, respectively, all P〈0.01） after treatment in GHD group, SGA group and ISS group.Children in three groups got satisfactory effects after 6-month treatment of rhGH.GHD group got the most significant change in△Ht,△HtSDS and△HV, but its therapeutic dose was lowest in three groups （F value was 4.425, 4.797 and 7.994, respectively, all P〈0.05） , which indicated that children with GHD obtained best effect in rhGH treatment.Comparison between pre-and post-treatment showed that △BMI and△IGF1 were not significant in three groups （all P〉0.05）.The total incidence of adverse events was 7.3%（3/41）, and the indice

关 键 词：矮小 重组人生长激素 疗效分析 安全性 

分 类 号：R179[医药卫生—妇幼卫生保健]