左甲状腺素片及生长激素在治疗甲状腺功能减退导致矮小症中的临床效果观察  

The clinical efficacy of levothyroxine and growth hormone in the treatment of dwarfism caused by hypothyroidism

作　　者：吴韬[1] 杜俊文[1] 张坤[1] 任巧华[1] 王欣[1] 梁屹[1] WU Tao;DU Jun-wen;ZHANG Kun;REN Qiao-hua;WANG Xin;LIANG Yi(The First Department of Endocrinology,the First Hospital of Shijiazhuang, Hebei Province,Shijiazhuang050011,China)

机构地区：[1]河北省石家庄市第一医院内分泌一科,河北石家庄050011

出　　处：《河北医科大学学报》2019年第1期25-28,共4页Journal of Hebei Medical University

基　　金：石家庄市科学技术研究与发展指导计划(161460683)

摘　　要：目的观察左甲状腺素片及生长激素在治疗甲状腺功能减退导致矮小症中的临床效果。方法选择确诊为甲状腺功能减退症导致的矮小症患儿80例,将患儿随机分为对照组(左甲状腺素片治疗)和试验组(左甲状腺素片+生长激素治疗)各40例。比较2组治疗前和治疗后3个月、6个月生长速度(growth velocity,GV)、身高标准差积分(height standard deviation score,HtSDS)、预测成年身高(prediction of adultheight,PAH)、骨龄(bone age,BA)、血清骨钙素(osteocalcin,OC)水平。记录治疗前后血清甲状腺激素(thyroxine,T4)水平变化情况。结果2组治疗后GV、HtSDS、PAH、OC水平均随时间逐渐升高,在治疗3个月时GV、HtSDS、PAH、OC水平无显著差异,治疗6个月时试验组GV、HtSDS、PAH、OC水平明显高于对照组,其组间、时点间、组间·时点间交互作用差异均有统计学意义(P<0.05)。2组BA组间、时点间、组间·时点间交互作用差异均无统计学意义(P>0.05)。2组治疗后3个月T4水平均明显升高,其时点间差异有统计学意义(P<0.05),而其组间、组间·时点间交互作用差异均无统计学意义(P>0.05)。结论左甲状腺素片联合重组人生长激素治疗甲状腺功能减退导致的矮小症患儿,可以促进其身高的增长,显著提高其甲状腺激素水平。Objective To study the exact effect of levothyroxine and growth hormone in the treatment of dwarfism caused by hypothyroidism.Methods Eighty children with short stature caused by hypothyroidism were selected and randomly divided into control group(levothyroxine tablet treatment)and experimental group(levothyroxine tablet+growth hormone treatment)according to different treatment methods,40cases in each group.Growth velocity(GV),height standard deviation score(HtSDS),predicted adult height(PAH),bone age(BA)and serum osteocalcin(OC)levels were compared before and after treatment for3and6months.The changes of serum thyroxine(T4)levels were recorded before and after treatment.Results The levels of GV,HtSDS,PAH and OC increased with time after treatment.There was no significant difference in GV,HtSDS,PAH and OC levels at3months of treatment.At6months of treatment,GV,HtSDS,PAH and OC levels in the experimental group were significantly higher than those in the control group.There were significant differences in the interactions among groups,time points,and between groups(P<0.05).There was no significant difference in the interaction between BA groups,time points and group-time point interaction P>0.05).T4levels in both groups increased significantly after3months of treatment(P<0.05).However,there was no significant difference in the interaction between T4groups,between groups and between time points after treatment P>0.05).Conclusion Levothyroxine combined with recombinant human growth hormone in the treatment of dwarfism caused by hypothyroidism can effectively promote the growth of height,and significantly increase the level of thyroid hormone.

关 键 词：生长障碍 甲状腺素 生长激素 

分 类 号：R59[医药卫生—内科学]