重组人生长激素联合促性腺激素释放激素类似物对青春期特发性身材矮小症男童身高及骨代谢水平的影响  

Effect of recombinant human growth hormone combined with gonadotropin releasing hormone analogue on height and bone metabolism in adolescent boys with idiopathic short stature

作　　者：徐德万 XU Dewan(Department of Pediatrics,Shangrao Municipal Hospital,Shangrao,Jiangxi,334000,China)

机构地区：[1]上饶市立医院儿科,江西上饶334000

出　　处：《当代医学》2024年第17期71-74,共4页Contemporary Medicine

摘　　要：目的探讨重组人生长激素(recombinant human growth hormone,rhGH)联合促性腺激素释放激素类似物(gonadotropin releasing hormone analogue,GnRHa)对青春期特发性身材矮小症(idiopathic short stature,ISS)男童身高及骨代谢水平的影响。方法选取2020年10月至2021年9月上饶市立医院收治的60例ISS男童作为研究对象,采用随机数字表法分为对照组与观察组,每组30例。对照组给予rhGH治疗,观察组给予rhGH联合GnRHa治疗。比较两组治疗前后生长参数[身高(height,Ht)、体质量(weight,Wt)、体重指数(body mass index,BMI)、生长速率(growth velocity,GV)、身高标准差积分(height standard deviation score,HtSDS)]、骨代谢指标{血清骨碱性磷酸酶(bone alkaline phosphatase,BAP)、胰岛素样生长因子-1(insulin-like growth factor-1,IGF-1)、25-羟维生素D[25-hydroxyvitaminD,25-(OH)D]}、血脂指标[总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、动脉粥样硬化指数(atherosclerosis index,AI)]及用药安全性。结果治疗12个月后,两组Ht、BMI、HtSDS均高于治疗前,Wt大于治疗前,GV快于治疗前,且观察组Ht、BMI、HtSDS均高于对照组,Wt大于对照组,GV快于对照组,差异有统计学意义(P<0.05)。治疗12个月后,两组BAP、IGF-1、25-(OH)D水平均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。治疗12个月后,两组HDL-C水平均高于治疗前,LDL-C水平、AI均低于治疗前,且观察组HDL-C水平高于对照组,LDL-C水平、AI均低于对照组,差异有统计学意义(P<0.05);两组组内、组间治疗前与治疗12个月后TC、TG水平比较差异无统计学意义。两组不良反应发生率比较差异无统计学意义。结论rhGH联合GnRHa治疗ISS男童可改善患儿骨代谢及血脂水平,促进其生长发育,安全性较高。Objective To investigate the effects of recombinant human growth hormone(rhGH)combined with gonadotropin releasing hormone analogue(GnRHa)on the height and bone metabolism in adolescent boys with idiopathic short stature(ISS).Methods 60 adolescent boys with ISS admitted to Shangrao Municipal Hospital from October 2020 to September 2021 were as the research subjectd,and they were divided into the control group and the observation group according to the random number table methods,with 30 cases in each group.The control group was treated with rh-GH,and the observation group was treated with rhGH combined with GnRHa.The growth parameters(height[Ht],weight[Wt],body mass index[BMI],growth rate[GV],height standard deviation score[HtSDS]),bone metabolism indicators(serum bone alkaline phosphatase[BAP),insulin-like growth factor-1[IGF-1],25 hydroxyvitamin D[25(OH)D])and blood lipid indicators(total cholesterol[TC],triglycerides[TG],high density lipoprotein cholesterol[HDL-C],low density lipoprotein cholesterol[LDL-C],atherosclerosis index[AI]),and evaluation of drug safety.Results After 12 months of treatment,the Ht,BMI and HtDS of the two groups were higher than those before treatment,Wt was greater than before treatment,and GV was faster than before treatment,and Ht,BMI and HtSDS in the observation group were higher than those in the control group,Wt was greater than that in the control group,and GV was faster than that in the control group,and the differences were statistically significant(P<0.05).After 12 months of treatment,the BAP,IGF-1 and 25-(OH)D of the two groups were higher than those before treatment,and the observation group was higher than the control group,and the differences were statistically significant(P<0.05).After 12 months of treatment,the HDL-C level of the two groups were higher than before treatment,LDL-C level and AI were lower than before treatment,and the HDL-C level in the observation group was higher than that in the control group,and LDL-C level and AI were lower than those in the control g

关 键 词：青春期特发性身材矮小症 重组人生长激素 促性腺激素释放激素类似物 男童 身高 骨代谢 

分 类 号：R72[医药卫生—儿科]