不同剂量重组人生长激素治疗小于胎龄儿矮小症的疗效分析  

Efficacy of different doses of recombinant human growth hormone in the treatment of short stature in children born small for gestational age

作　　者：且迪 杨凡[1] 

机构地区：[1]四川大学华西第二医院儿科,四川成都610041

出　　处：《中国当代儿科杂志》2016年第3期247-253,共7页Chinese Journal of Contemporary Pediatrics

摘　　要：目的研究不同剂量重组人生长激素（rh GH）治疗小于胎龄儿（SGA）矮小症的效果和安全性。方法收集SGA矮小症患儿37例,并根据使用剂量分为2组：小剂量（每日0.1~0.15IU/kg）rh GH治疗组和大剂量rh GH治疗组（每日0.16~0.2IU/kg）,比较两组患儿治疗后3、6、9、12及24个月时身高标准差的增长值（ΔHt SDS）、生长速率（HV）、血清胰岛素样生长因子-1（IGF-1）、胰岛素样生长因子结合蛋白-3（IGFBP-3）水平及空腹血糖等指标的变化。结果大、小剂量rh GH治疗后ΔHt SDS及HV均有提高,但大剂量组治疗后9、12及24个月时ΔHt SDS及HV均高于小剂量组（P〈0.05）。大剂量和小剂量的rh GH治疗均使血清IGF-1和IGFBP-3水平提高,且血清IGF-1和IGFBP-3水平与Ht SDS呈正相关。大小剂量组各有1例患儿出现一过性空腹血糖轻微升高（均为6.1mmol/L）;两组甲状腺功能均无异常。结论 rh GH治疗SGA矮小症效果确切,不良反应少,其中大剂量较小剂量治疗更具优势。Objective To investigate the efficacy and safety of different doses of recombinant human growth hormone（rh GH） in the treatment of short stature in children born small for gestational age（SGA）. Methods A total of 37 children with short stature born SGA were enrolled, and based on the dose of rh GH treatment, they were divided into low-dose rh GH group（0.1-0.15 IU/kg daily） and high-dose rh GH group（0.16-0.2 IU/kg daily）. The changes in height standard deviation score（ΔHt SDS）, height velocity（HV）, serum levels of insulin-like growth factor-1（IGF-1） and insulin-like growth factor binding protein-3（IGFBP-3）, and fasting blood glucose at 3, 6, 9, 12, and 24 months after treatment were compared between the two groups. Results ΔHt SDS and HV both increased after the treatment with high- and low-dose rh GH, but ΔHt SDS and HV in the high-dose rh GH group were significantly higher than in the lowdose rh GH group 9, 12 and 24 months after treatment（P〈0.05）. Both high- and low-dose rh GH treatment increased serum levels of IGF-1 and IGFBP-3. Serum levels of IGF-1 and IGFBP-3 were positively correlated with Ht SDS in both groups. One child each in the high- and low-dose rh GH groups experienced transient slight increase in fasting blood glucose（6.1 mmol/L）. There were no cases of abnormal thyroid function. Conclusions rh GH has good efficacy in the treatment of short stature in children born SGA, with few adverse events, and high-dose rh GH has some advantages over low-dose rh GH.

关 键 词：重组人生长激素 生长速率 治疗剂量 小于胎龄儿 儿童 

分 类 号：R725.8[医药卫生—儿科]