维生素D联合重组人生长激素对特发性矮小症患儿生长发育和血清Ghrelin、IGF-1、IGFBP-3水平的影响  

Effects of vitamin D combined with recombinant human growth hormone on growth and development,serum ghrelin,IGF-1 and IGFBP-3 in children with idiopathic short stature

作　　者：胡航嘉 孟婕 张瑞欣 牧丰苗 姜志红[1] HU Hangjia;MENG Jie;ZHANG Ruixin;MU Fengmiao;JIANG Zhihong(School of Clinical Medicine/Department of Child Health Care,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang,Henan,China,471003)

机构地区：[1]河南科技大学临床医学院/河南科技大学第一附属医院儿童保健科,河南洛阳471003

出　　处：《分子诊断与治疗杂志》2024年第10期1952-1956,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河南省中国科学院科技成果转移转化项目(2018105)。

摘　　要：目的探讨维生素D(VD)联合重组人生长激素(rhGH)对特发性矮小症患儿疗效及对生长发育指标和食欲刺激素(Ghrelin)、血清胰岛素样生长因子-1(IGF-1)、胰岛素样生长因子结合蛋白-3(IGFBP-3)水平的影响。方法选取2021年6月至2023年8月在河南科技大学第一附属医院进行治疗的152例特发性矮小症患儿,按照随机数表法将患儿分为hGH组和VD联合激素组,各纳入76例。hGH组患儿采用生长激素(hGH)治疗,VD联合激素组采用VD联合重组人生长激素治疗,均持续治疗3个月。比较两组生长发育情况[身高、体质量、骨龄和生长速度]、骨代谢水平[25羟维生素D[25(OH)D]、骨碱性磷酸酶(BAP)和骨钙素(OC)]、甲状腺功能指标[游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)和促甲状腺激素(TSH)]、血清学指标[血清胰岛素样生长因子-1(IGF-1)和胰岛素样生长因子结合蛋白-3(IGFBP-3)]和不良反应发生率。结果治疗后,VD联合激素组的身高较hGH组高、体质量较hGH组重、骨龄均较hGH组大、生长速度较hGH组快,差异均有统计学意义(P<0.05);VD联合激素组25(OH)D、BAP和OC水平均较hGH组高,差异有统计学意义(P<0.05);VD联合激素组的FT3水平较hGH组高,FT3和FT4水平均较治疗前升高,差异有统计学意义(P<0.05);VD联合激素组的Ghrelin较hGH组低,IGF-1和IGFBP-3水平均较hGH组高,差异有统计学意义(P<0.05)。VD联合激素组的不良反应率为18.42%,hGH组为11.84%,两组比较差异无统计学意义(P>0.05)。结论VD联合重组人生长激素治疗对特发性矮小症患儿的生长发育具有较好促进作用,可提高其骨代谢水平,改善患儿甲状腺功能。Objective To explore the curative effect of vitamin D(VD)combined with recombinant human growth hormone(rhGH)and its influences on growth and development indexes,serum ghrelin(Ghrelin),insulin-like growth factor 1(IGF-1)and insulin-like growth factor binding protein-3(IGFBP-3)in children with idiopathic short stature.Methods A total of 152 children with idiopathic short stature treated at the First Affiliated Hospital of Henan University of Science and Technology were enrolled between June 2021 and August 2023.Based on random number table method,they were divided into the hGH group and the VD-hormone group,with 76 cases in each group.The hGH group was treated with growth hormone(hGH),while the VD-hormone group was treated with vitamin D+rhGH for 3 months.The growth and development indexes(height,body mass,bone age,growth rate),bone metabolism indexes[25-hydroxyvitamin D[25(OH)D,bone alkaline phosphatase(BAP),osteocalcin(OC)],thyroid function indexes[free triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH)],serological indexes(IGF-1,IGFBP-3)and the incidence of adverse reactions in the two groups were compared.Results After treatment,the height,body mass,bone age and growth rate in the VD-hormone group were higher than those in the hGH group(P<0.05).The levels of 25(OH)D,BAP and OC in the VD-hormone group were higher than those in the hGH group(P<0.05).The FT3 level in the VD-hormone group was higher than that in the hGH group,and both FT3 and FT4 levels increased after treatment(P<0.05).The ghrelin level in the VD-hormone group was lower than that in the hGH group,while IGF-1and IGFBP-3 levels were higher than those in the hGH group(P<0.05).There was no significant difference in the incidence of adverse reactions between the VD-hormone group and the hGH group(18.42%vs 11.84%,P>0.05).Conclusion Vitamin D combined with rhGH can effectively promote growth and development,improve bone metabolism,and enhance thyroid function in children with idiopathic short stature.

关 键 词：重组人生长激素 特发性矮小症 食欲刺激素 胰岛素样生长因子-1 胰岛素样生长因子结合蛋白-3 

分 类 号：R725.8[医药卫生—儿科]