AI联合rhGH对男性特发性矮小症患儿生长速率、骨密度及骨代谢的影响  

Effect of AI Combined with rhGH on Growth Rate,Bone Mineral Density and Bone Metabolism of Children with Idiopathic Dwarfism

作　　者：宋靖荣[1] 董焱[1] SONG Jingrong;DONG Yan(Department of Pediatrics,Shanghai Ninth People′s Hospital Affiliated to School of Medicine,Shanghai Jiaotong University,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院儿科,上海200011

出　　处：《医学综述》2020年第24期4952-4956,共5页Medical Recapitulate

摘　　要：目的分析芳香化酶抑制剂(AI)联合重组人生长激素(rhGH)对男性特发性矮小症患儿生长速率、骨密度及骨代谢的影响。方法选取2015年1月至2017年11月上海交通大学医学院附属第九人民医院儿科收治的48例男性特发性矮小症患儿为研究对象,按照随机数字表法分为对照组和研究组,每组24例。对照组采用rhGH治疗,研究组采用AI联合rhGH治疗,比较两组治疗前后身高、体质指数、生长速率、骨龄、骨密度及骨代谢指标[骨钙素(OC)、胰岛素样生长因子1(IGF-1)、骨碱性磷酸酶(BALP)、血清β-胶原降解产物(β-CTX)及Ⅰ型前胶原N端前肽(PINP)]水平。结果不考虑测量时间,两组间身高、生长速率、骨龄的主效应差异有统计学意义(P<0.05);身高、生长速率、骨龄的时点间与组间存在交互作用(P<0.05),而体质指数、骨密度的时点间与组间不存在交互作用(P>0.05),两组治疗前后身高、生长速率、骨龄的变化幅度不同,观察组变化更明显。不考虑测量时间,两组间OC、IGF-1、BALP、β-CTX、PINP的主效应差异无统计学意义(P>0.05),OC、IGF-1、BALP、β-CTX、PINP的时点间与组间不存在交互作用(P>0.05)。结论与单纯rhGH相比,AI联合rhGH更有利于男性特发性矮小症患儿的身高增长,并可明显改善骨龄提前,且未明显影响患儿骨代谢、骨密度。Objective To analyze the effect of aromatase inhibitors(AI)joint recombinant human growth hormone(rhGH)on the growth rate,bone mineral density and bone metabolism of male children with idiopathic dwarfism.Methods A total of 48 male children with idiopathic dwarfism admitted to the Department of Pediatrics,Shanghai Ninth People′s Hospital Affiliated to School of Medicine,Shanghai Jiaotong University from Jan.2015 to Nov.2017 were included and divided into a control group and a study group according to random number table method,24 cases each group.The study group was treated with the AI joint rhGH treatment,and the control group was treated only with rhGH treatment.The children′s height,body mass index,growth rate,bone age and bone mineral density and bone metabolism index[osteocalcin(OC),insulin-like growth factor 1(IGF-1),bone alkaline phosphatase(BALP),serumβcollagen degradation products(β-CTX)and typeⅠcollagen N terminal propeptide(PINP)]levels of the two groups before and after treatment were compared.Results Regardless of the measurement time,the main effects of body height,growth rate and bone age between the two groups were statistically significant(P<0.05).The body height,growth rate and bone age showed interactions between time points and groups(P<0.05),while the body mass index and bone mineral density did not show interactions between time points and groups(P>0.05).The changing amplitudes before and after treatment of body height,growth rate and bone age of the two groups were different,and the changes were more obvious in the study group.Regardless of the measurement time,the main effects of OC,IGF-1,BALP,-CTX and PINP were not significantly different between the two groups(P>0.05).There was no interactions in OC,IGF-1,BALP,β-CTX and PINP between time points and groups(P>0.05).Conclusion Compared with the simple application of rhGH,AI and rhGH joint application of synergy is more advantageous to the height growth of children with male idiopathic dwarfism,obviously improve the patient′s prem

关 键 词：特发性矮小症 芳香化酶抑制剂 重组人生长激素 骨密度 骨代谢 

分 类 号：R725.8[医药卫生—儿科]