不同剂量重组人生长激素治疗对特发性矮小症患儿骨代谢、甲状腺功能和血清Ghrelin、IGF-1水平的影响  

Effects of Different Doses of Recombinant Human Growth Gormone on Bone Metabolism,Thyroid Function and Serum Levels of Ghrelin and IGF-1 in Children with Idiopathic Short Stature

作　　者：肖青凤 吴琰 史晓宁 钟贞 苏志谦[1] XIAO Qing-feng;WU Yan;SHI Xiao-ning;ZHONG Zhen;SU Zhi-qian(Department of Pediatrics,The First Affiliated Hospital of Hunan College of Traditional Chinese Medicine/Hunan Provincial Hospital of Traditional Chinese Medicine,Zhuzhou,Hunan,412000,China;Department of Emergency Pediatrics,Hubei Maternal and Child Health Hospital Wuhan,Hubei,430070,China)

机构地区：[1]湖南中医药高等专科学校附属第一医院/湖南省直中医医院儿科,湖南株洲412000 [2]湖北省妇幼保健院急诊儿科,湖北武汉430070

出　　处：《现代生物医学进展》2021年第23期4569-4572,4582,共5页Progress in Modern Biomedicine

基　　金：湖南省中医药管理局一般项目(201668)。

摘　　要：目的:探讨不同剂量重组人生长激素(r HGH)治疗对特发性矮小症(ISS)患儿骨代谢、甲状腺功能和血清食欲刺激素(Ghrelin)、胰岛素样生长因子-1(IGF-1)水平的影响。方法:选取2017年3月~2020年2月期间来我院接受治疗的ISS患儿60例,根据随机数字表法分为低剂量组(给予剂量0.10 U/kg·d进行治疗)和高剂量组(给予剂量0.20 U/kg·d进行治疗),各为30例。比较两组患儿生长发育情况[身高、体重、生长速度(GV)、身高标准积分(Ht SDS)]、骨代谢[骨碱性磷酸酶(BAP)、I型前胶原氨基端前肽(PINP)、I型胶原交联羧基末端肽(β-CTX)]、甲状腺功能[促甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)]和血清Ghrelin、IGF-1水平。观察不良反应发生情况。结果:治疗1年后,高剂量组身高、体重、GV、Ht SDS高于低剂量组(P<0.05)。高剂量组治疗1年后BAP、PINP高于低剂量组,β-CTX低于低剂量组(P<0.05)。两组患儿治疗1年后TSH、FT3、FT4组内对比无统计学差异(P>0.05)。高剂量组Ghrelin低于低剂量组,IGF-1水平高于低剂量组(P<0.05)。两组总的不良反应发生率组间对比无统计学差异(P>0.05)。结论:相对于0.10 U/kg·d剂量的r HGH,0.20 U/kg·d剂量的r HGH可更好的促进ISS患儿生长发育,调节骨代谢和血清Ghrelin、IGF-1水平,且对人体甲状腺功能无影响。Objective:To investigate the effects of different doses of recombinant human growth hormone(rhGH)on bone metabolism,thyroid function and the levels of serum appetite stimulating hormone(Ghrelin)and insulin like growth factor-1(IGF-1)in children with idiopathic short stature(ISS).Methods:60 children with ISS who were treated in our hospital from March 2017 to February2020 were selected,and according to random number table,they were divided into low-dose group(given 0.10 U/kg·d dose for treatment)and high-dose group(given 0.20 U/kg·d dose for treatment),30 cases in each group.The growth and development[height,body weight,growth rate(GV),height standard score(Ht SDS)],bone metabolism[bone alkaline phosphatase(BAP),amino terminal propeptide of procollagen type I(PINP)and cross linked carboxyl terminal peptide of collagen type I(β-CTX)],thyroid function[thyroid stimulating hormone(TSH),free triiodothyronine(FT3),free thyroxine(FT4)]and serum Ghrelin,IGF-1 levels were compared between the two groups.Adverse reactions were observed.Results:1 year after treatment,the height,body weight,GV and Ht SDS in high-dose group were higher than those in low-dose group(P<0.05).1 year after treatment,BAP and PINP in high-dose group were higher than those in low-dose group,andβ-CTX was lower than that in low-dose group(P<0.05).There were no significant differences in TSH,FT3 and FT4 between the two groups at 1 year after treatment(P>0.05).Ghrelin in high-dose group was lower than that in low-dose group,and the level of IGF-1 was higher than that in low-dose group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Compared with the 0.10 U/kg·d dose of r HGH,the 0.20 U/kg·d dose of r HGH can better promote the growth and development of children with ISS,regulate bone metabolism,serum Ghrelin and IGF-1 levels,and which has no effect on human thyroid function.

关 键 词：重组人生长激素 特发性矮小症 骨代谢 甲状腺功能 Ghrelin IGF-1 

分 类 号：Q593[生物学—生物化学] R72[医药卫生—儿科]