来曲唑改善青春期特发性矮小症男童身高的疗效观察  

Effect of lelrozol on height of adolescent boys of idiopathic short stature

作　　者：张蔷[1] 刘丽君[1] 李金英[1] 侯晓娜 张晓军 ZHANG Qiang;LIU Lijun;LI Jinying;HOU Xiaona;ZHANG Xiaojun(Hebei Children's Hospital,Shijiazhuang 050031,China)

机构地区：[1]河北省儿童医院,石家庄050031

出　　处：《实用医学杂志》2021年第3期369-373,共5页The Journal of Practical Medicine

基　　金：河北省卫生健康委青年科技课题(编号:20190843)。

摘　　要：目的研究青春期特发性矮小症(ISS)患儿采用重组人生长激素(rhGH)、rhGH联合来曲唑及rhGH联合促性腺激素释放激素类似物(GnRha)治疗对改善其预测终身高的影响。方法从我院2014年5月至2019年6月收治的ISS患儿60例,采用随机分组法分为3组,其中20例为rhGH组(单用rhGH治疗),20例为GnRha组(采用rhGH联合醋酸亮丙瑞林治疗),20例为来曲唑组(采用rhGH联合来曲唑治疗),3组患儿均治疗1年,收集分析3组患儿治疗期间身高、体质量、生长速率、骨龄、空腹血糖、糖化血红蛋白、IGF-1、IGFBP3,预测终身高、不良反应。结果 3组患儿治疗前基础资料差异无统计学意义(P> 0.05),治疗1年后,骨龄rhGH组[(14.49±0.51)岁]大于来曲唑组[(13.77±0.74)岁]和GnRha组[(13.78±0.52)岁](P <0.05),来曲唑组骨龄增长[(0.17±0.14)岁]明显小于GnRha组[(0.49±0.16)岁]和rhGH组[(0.97±0.13)岁](P <0.05)。来曲唑组预测终身高[(165.40±2.57)cm]明显高于GnRha组[(162.32±2.82)cm]和rhGH组[(161.32±1.32)cm](P <0.05),预测终身高增加来曲唑组[(6.86±1.14)cm]大于GnRha组[(4.03±0.79)cm],GnRha组大于rhGH组[(2.66±0.71)cm](P <0.05)。生长速率来曲唑组[(8.19±0.26)cm]和rhGH组[(8.44±0.94)cm]明显大于GnRha组[(7.51±0.96)cm](P <0.05)。3组之间空腹血糖、糖化血红蛋白、IGF-1、IGFBP3、不良反应差异无统计学意义(P>0.05)。结论对于青春期的ISS男童来曲唑比醋酸亮丙瑞林改善预测终身高的效果更明显。Objective To investigate the effects of different therapy strategy,including single recombinant human growth hormone(rhGH)use,combination of rhGH and letrozole,and combination of rhGH and GnRHa,in improving the prediction of final height in children diagnosed with adolescent idiopathic short stature(ISS).Methods From May 2014 to June 2019,60 children with ISS in our hospital were randomly divided into three groups,20 cases in rhGH group(rhGH alone),20 cases in GnRHa group(rhGH combined with leuprorelin),and 20 cases with letrozole group(treated with rhGH combined with letrozole).All the three groups were treated and followed up for 1 year.Parameters of weight,growth rate,bone age,fasting blood glucose,glycosylated hemoglobin,IGF-1 and IGFBP3 were collected and analyzed to predict the final height and adverse reactions.Results:There was no significant difference in basic data among the three groups before treatment(P>0.05).After 1 year of treatment,the bone age of rhGH group(14.49±0.51 years old)was higher than that of letrozole group(13.77±0.74 years old)and GnRHa group(13.78±0.52 years old)(P<0.05).The bone age growth of letrozole group(0.17±0.14 years old)was significantly less than that of GnRHa group(0.49±0.16 years old)and rhGH group(0.97±0.13 years old)(P<0.05).The predicted final height in letrozole group(165.40±2.57 cm)was significantly higher than that in GnRHa group(162.32±2.82 cm)and rhGH group(161.32±1.32 cm)(P<0.05).The predicted final height increase in letrozole group(6.86±1.14 cm)was higher than that in GnRHa group(162.32±2.82 cm),that in GnRHa group was higher than that in rhGH group(2.66±0.71 cm)(P<0.05).The growth rate of letrozole group(8.19±0.26 cm)and rhGH group(8.44±0.94 cm)was significantly higher than that of GnRHa group(7.51±0.96 cm)(P<0.05).There was no significant difference in fasting blood glucose,glycosylated hemoglobin,IGF-1,IGFBP3 and adverse reactions among the three groups(P>0.05).Conclusion Letrozole is more effective than GnRHa in improving the predict final hei

关 键 词：特发性矮小症 来曲唑 GNRHA RHGH 预测终身高 

分 类 号：R725.8[医药卫生—儿科]