生长激素治疗2年对生长激素缺乏症患儿生长指标及糖脂代谢水平的影响  

Effect of growth parameters and analysis of glucose and lipid metabolism in children with GHD treated with rhGH for 2 years

作　　者：夏露露[1] 闫洁[1] 杨文利[1] 赵文利[1] Xia Lulu;Yan Jie;Yang Wenli;Zhao Wenli(Department of Clinical Nutrition,National Center for Children's Health&Beijing Children's Hospital,Capital Medical University,Beijing100045,China)

机构地区：[1]国家儿童医学中心,首都医科大学附属北京儿童医院临床营养科,北京100045

出　　处：《中国综合临床》2025年第1期50-59,共10页Clinical Medicine of China

摘　　要：目的观察生长激素缺乏症(growth hormone deficiency,GHD)患儿使用重组人生长激素(recombinant human growth hormone,rhGH)治疗2年,生长指标及糖脂代谢指标的改变,并分析性别及年龄对这些指标的影响。方法选取2016年7月至2022年12月首都医科大学附属北京儿童医院内分泌营养专业门诊收治的80例GHD患儿的临床资料进行回顾性分析,所有患儿均使用rhGH治疗。收集并计算治疗前及治疗3、6、12、18、24个月时患儿生长指标、生长因子、糖代谢、脂代谢等指标,分析性别及年龄对这些指标的影响及这些指标与身高增长速率(height growth velocity,HGV)之间的相关性。正态分布的计量资料两组之间比较采用独立样本t检验;多组间比较采用单因素方差分析,两两比较采用LSD-t检验。非正态分布的计量资料以M(Q1,Q3)表示,采用非参数秩和检验。采用Pearson相关分析法分析HGV与各指标之间的相关性。结果共纳入80例患儿,男39例,女41例。按照年龄段分组,3.00~5.99岁组20例;6.00~9.99岁组共有41例;≥10.00岁组19例。所有患儿在治疗24个月身高[(135.13±13.17)cm]、身高标准差积分(height standard deviation score,HtSDS)[-0.73(-1.04,-0.41)]、体质量[29.25(23.13,35.00)kg]、体质量标准差积分(weight standard deviation score,WtSDS)[-0.44(-1.03,0.03)]、体质量指数(body mass index,BMI)[15.99(14.90,16.92)kg/m2]较治疗前[(115.44±12.87)cm、-2.11(-2.57,-2.03)、20.00(16.00,25.00)kg、-1.48(-2.12,-0.89)、15.30(14.45,16.21)kg/m2]均升高,差异均有统计学意义(均P<0.05)。3.00~5.99岁组HtSDS的增幅(1.74±0.29)高于6.00~9.99岁组(1.57±0.33)和≥10.00岁组(1.39±0.45),差异有统计学意义(F=4.84,P=0.010)。所有患儿在治疗24个月胰岛素样生长因子1(insulin-like growth factor-1,IGF-1)[329.50(268.00,417.25)μg/L]、胰岛素样生长因子结合球蛋白3(insulin-like growth factor binding globulin-3,IGFBP-3)[6.27(5.50,6.95)mg/L]较治疗前[131.50(96.48,177.25)μg/ObjectiveTo observe the changes of growth parameters and glucose and lipid metabolism indexes in GHD children treated with rhGH for 2 years,and analyze the influence of sex and age on these indexes.MethodsClinical data of children with 80 cases GHD admitted to the Endocrine and Nutrition Clinic of the Beijing Children's Hospital affiliated to the Capital Medical University from July 2016 to December 2022 were analyzed retrospectively.All patients were treated with rhGH.The growth parameters,growth factors,glucose metabolism and lipid metabolism indexes were collected and calculated before treatment and at 3,6,12,18 and 24 months after treatment,the influence of sex and age on these indexes and the correlations between these indicators and height growth rate were analyzed.Independent-sample t-test was used to compare two groups with normal distribution,one-way ANOVA was used to compare multiple groups,and repeated measures ANOVA was used to compare the mean of each time point within groups.The nonparametric rank sum test was used for the comparison of non-normal distribution measurement data.Pearson correlation analysis was used to analyze the correlation between HGV and each index.ResultsA total of 80 children were enrolled,39 boys and 41 girls.Grouped by age,there were 20 in the 3.00-5.99 age group,41 in the 6.00-9.99 age group,and 19 in the≥10.00 age group.All patients after 24 months of treatment had a higher height((135.13±13.17)cm),HtSDS(-0.73(-1.04,-0.41)),body weight(29.25(23.13,35.00)kg),weight standard deviation score(WtSDS)(-0.44(-1.03,0.03)),and body mass index(BMI)(15.99(14.90,16.92)kg/m 2)compared to before treatment((115.44±12.87)cm,-2.11(-2.57,-2.03),20.00(16.00,25.00)kg,-1.48(-2.12,-0.89)and 15.30(14.45,16.21)kg/m 2)all increased,and the differences were statistically significant(all P<0.05).The increase in HtSDS in the group aged 3.00-5.99(1.74±0.29)was higher than that in the group aged 6.00-9.99(1.57±0.33)and≥10.00(1.39±0.45),and the difference was statistically significant(F=4.84,P=0.

关 键 词：生长激素缺乏症 重组人生长激素 生长指标 糖代谢 脂代谢 

分 类 号：R72[医药卫生—儿科]