不同BMI的特发性矮小症患儿应用重组人生长激素治疗的疗效及安全性分析  

Efficacy and Safety Analysis of Recombinant Human Growth Hormone Therapy in Children with Idiopathic Short Stature with Different Body Mass Indexes

作　　者：张文慧 许峥嵘[2] ZHANG Wen-hui;XU Zheng-rong(Graduate School,Hebei North University,Zhangjiakou,075000,China;Endocrinology Department,The First Affiliated Hospital of Hebei North University,Zhangjiakou,075000,China)

机构地区：[1]河北北方学院研究生学院,张家口075000 [2]河北北方学院附属第一医院内分泌科,张家口075000

出　　处：《神经药理学报》2024年第3期47-53,共7页Acta Neuropharmacologica

摘　　要：目的:分析不同体重指数(body mass index,BMI)的特发性矮小症(idiopathic short stature,ISS)患儿在重组人生长激素(recombinant human growth hormone,rhGH)治疗下的疗效差异及安全性。方法:选取于河北北方学院附属第一医院接受rhGH治疗的ISS患儿为研究对象,根据7岁以下儿童生长标准及中国6~18岁学龄儿童青少年性别、年龄、体质指数、超重与肥胖界值,将ISS患儿分为BMI正常组、超重组、肥胖组,测定三组患儿治疗前、治疗3个月及6个月后的身高(height,Ht)、BMI、生长速率(growth velocity,GV)、身高标准差积分(height standard deviation score,HtSDS)、胰岛素样生长因子-1(insulin like growth factor-1,IGF-1)、胰岛素样生长因子结合蛋白-3(insulin like growth factor binding-protein-3,IGFBP-3)、空腹血糖(fasting blood glucose,FBG)、甲状腺功能及肝功能。结果:三组ISS患儿在rhGH治疗后Ht、GV、HtSDS、IGF-1、IGFBP-3均较治疗前增加(P<0.05)。BMI正常组患儿Ht、GV和HtSDS增长量明显高于超重组及肥胖组(P<0.05),超重组与肥胖组相比无明显差异(P>0.05)。BMI正常组患儿在治疗6个月后BMI较治疗前增加(P<0.05),而超重组及肥胖组BMI均较前下降(P<0.05)。rhGH治疗对FBG、甲状腺功能、肝功能无明显影响。结论:rhGH能明显提高ISS患儿的Ht、HtSDS、GV、IGF-1、IGFBP-3水平,BMI正常的ISS患儿的疗效明显好于超重组及肥胖组,超重及肥胖ISS患儿疗效无明显差异,rhGH治疗具有较好的安全性。Objective:This article aims to analyze the differences in efficacy and safety of recombinant human growth hormone(rhGH)treatment in children with idiopathic short stature(ISS)with different body mass indexes(BMI).Methods:ISS patients who received rhGH treatment at the First Affiliated Hospital of Hebei North University were selected as the research subjects.According to the growth standards for children under 7 years old and the gender age specific body mass index(BMI)overweight and obesity thresholds for Chinese school aged children and adolescents aged 6~18,ISS patients were divided into normal BMI group,overweight group and obese group.The height(Ht),body mass index(BMI),growth velocity(GV),height standard deviation score(HtSDS),insulin like growth factor-1(IGF-1),insulin like growth factor binding-protein-3(IGFBP-3),fasting blood glucose(FBG),thyroid function and liver function of three groups were measured before treatment,3 months after treatment,and 6 months after treatment.Results:After rhGH treatment,the levels of Ht,GV,HtSDS,IGF-1,and IGFBP-3 in the three groups of ISS patients increased compared to before treatment(P<0.05).The amount of increase in Ht,GV,and HtSDS in children with normal BMI were significantly higher than those in the overweight and obese groups(P<0.05),while there was no significant difference between the overweight group and obese group(P>0.05).After 6 months of treatment,the BMI of children with normal BMI increased compared to before treatment(P<0.05),while the BMI of overweight group and obese group decreased compared to before(P<0.05).rhGH treatment has no significant effect on fasting blood glucose,thyroid function and liver function.Conclusion:rhGH can significantly increase the levels of Ht,HtSDS,GV,IGF-1,and IGFBP-3 in children with ISS.The therapeutic effect of ISS patients with normal BMI is significantly better than that of overweight group and obese group.There is no significant difference in the therapeutic effect between overweight and obese ISS patients,and rhGH treatm

关 键 词：特发性矮小症 体重指数 重组人生长激素 

分 类 号：R969[医药卫生—药理学]