重组人生长激素治疗儿童身材矮小症的疗效及安全性研究  

Analysis of the efficacy and safety of recombinant human growth hormone in the treatment of short stature in children

作　　者：汪正飞 杨利琦[1] WANG Zhengfei;YANG Liqi(Department of Pediatrics,the Second Affiliated Hospital of Anhui Medical University,Anhui 230601,Hefei,China)

机构地区：[1]安徽医科大学第二附属医院儿科,安徽合肥230601

出　　处：《中国现代医生》2023年第17期41-44,共4页China Modern Doctor

摘　　要：目的探究重组人生长激素(recombinant human growth hormone,rhGH)治疗儿童身材矮小症的疗效及安全性。方法选取2015年11月至2019年11月在安徽医科大学第二附属医院接受rhGH治疗超过2年的115例患儿,按照疾病分为特发性身材矮小症(idiopathic short stature,ISS)组(n=54)及生长激素缺乏症(growth hormone deficiency,GHD)组(n=61)。比较两组患儿治疗前、治疗3个月、治疗6个月、治疗1年及治疗2年时的身高、生长速率(growth velocity,GV)、空腹血糖、游离三碘甲状腺原氨酸(free triiodothyronine,FT3)、游离甲状腺素(free thyroxine,FT4)、促甲状腺激素(thyroid stimulating hormone、TSH)、胰岛素样生长因子(insulin-like growth factor,IGF-1)、胰岛素样生长因子结合蛋白(insulin-like growth factor binding protein,IGFBP-3),对比rhGH治疗ISS及GHD患儿的疗效及安全性。结果治疗后各监测时间点,两组患儿的GV、空腹血糖、IGF-1、IGFBP-3均显著高于治疗前(P<0.05)。治疗后各监测时间点的两组患儿身高均较治疗前有所增加,其中治疗6个月、治疗1年及治疗2年时GHD组患儿身高显著高于治疗前(P<0.05),治疗1年及治疗2年时ISS组患儿身高显著高于治疗前(P<0.05)。治疗后各监测时间点,两组患儿TSH水平及ISS组FT3水平与治疗前比较,差异均无统计学意义(P>0.05)。治疗后各监测时间点,GHD组FT3水平均高于治疗前,其中治疗6个月时,患儿FT3水平显著高于治疗前(P<0.05)。治疗6个月、治疗1年,两组患儿FT4水平与治疗前比较,差异均无统计学意义(P>0.05),治疗3个月及治疗2年时,GHD组患儿FT4水平显著低于治疗前,治疗3个月时,ISS组患儿FT4水平显著低于治疗前(P<0.05)。使用rh GH治疗2年的患儿随访结果显示,GHD组的TSH出现异常的发生率显著高于ISS组(P<0.05),两组其余指标异常发生率比较,差异均无统计学意义(P>0.05)。结论rh GH能显著提高身材矮小症患儿身高及GV水平,安全性较高,建�Objective To investigate the efficacy and safety of recombinant human growth hormone(rhGH)in the treatment of short stature in children.Methods A total of 115 children who received rhGH treatment for more than 2 years at the Second Affiliated Hospital of Anhui Medical University from November 2015 to November 2019 were selected and divided into idiopathic short stature(ISS)group(n=54)and growth hormone deficiency(GHD)group(n=61).The height,growth velocity(GV),fasting blood glucose,free triiodothyronine(FT3),free thyroxine(FT4)thyroid stimulating hormone(TSH),insulin-like growth factor(IGF-1),insulin-like growth factor binding protein(IGFBP-3)at the time of initial treatment were compared between the two groups before treatment,at 3 months,6 months,1 year and 2 years of treatment.Results GV,fasting glucose,IGF-1 and IGFBP-3 were significantly higher in both groups than those before treatment at all post-treatment monitoring time points(P<0.05).The height of children in both groups increased at all post-treatment monitoring time points compared to pre-treatment,with children in the GHD group being significantly taller than that of pre-treatment at 6 months,1 year and 2 years of treatment(P<0.05),and the height of children in the ISS group significantly higher than that of pre-treatment at 1 year and 2 years of treatment(P<0.05).The difference between the TSH levels of the children in both groups and the FT3 levels in the ISS group at all post-treatment monitoring time points was not statistically significant compared with that before treatment(P>0.05).The FT3 level in the GHD group was higher than that before treatment at all post-treatment monitoring time points,with a statistically significant difference at 6 months of treatment(P<0.05).The difference between the FT4 levels of children in both groups at 6 months,1 year of treatment was not statistically significant(P>0.05),and the FT4 level of children in GHD group at 3 months and 2 years of treatment was significantly lower than that before treatment;the FT4 lev

关 键 词：重组人生长激素 身材矮小症 空腹血糖 甲状腺功能 

分 类 号：R179[医药卫生—妇幼卫生保健]