不同剂量重组人生长激素治疗特发性矮小症男童疗效研究  

Effects of different doses of recombinant human growth hormone on idiopathic short stature in boys

作　　者：司马燕[1] 唐雪骁[1] 戚胡敏[1] 何蓉[1] Sima Yan;Tang Xuexiao;Qi Humin;He Rong(Department of Pediatrics,Jiangyin Hospital of Traditional Chinese Medicine,Wuxi 214400,China)

机构地区：[1]江阴市中医院儿科,江苏无锡214400

出　　处：《海军医学杂志》2025年第4期373-377,共5页Journal of Navy Medicine

基　　金：江苏省科技计划专项/基础研究计划自然科学基金(BK20220468)。

摘　　要：目的探讨不同剂量重组人生长激素(rhGH)对特发性矮小症男童疗效的差异及其对骨代谢标志物、甲状腺功能、类胰岛素样生长因子的影响。方法选取2020年4月至2023年4月江阴市中医院收治的特发性矮小症男童80例,根据接受rhGH治疗剂量分为低剂量组(每周0.26 mg/kg)、中剂量组(每周0.35 mg/kg)与高剂量组(每周0.41 mg/kg),每组男童分别为29、27、24例,根据男童治疗情况疗程为1~2年。统计并比较3组男童治疗前后身高、体重、生长速度、身高标准差积分、骨密度、骨龄、骨代谢标志物[血清25羟维生素D、骨碱性磷酸酶(BAP)、骨钙素(OC)]、甲状腺功能[游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)]、类胰岛素样生长因子⁃1(IGF⁃1)及类胰岛素样生长因子结合蛋白⁃3(IGFBP⁃3)水平。结果治疗1、2年后,3组男童身高、体重、生长速度、身高标准差积分、骨密度、骨龄均上升(P_(时间)<0.05),血清25羟维生素D、BAP、OC均升高,且组间与时间差异均有统计学意义(P_(组间)<0.05、P_(时间)<0.05)。随治疗时间推进,3组特发性矮小症男童血清IGF⁃1、IGFBP⁃3升高(P_(时间)<0.05)。高剂量组男童出现关节疼痛、注射部位水肿及高血糖的例数(25.00%)多于低、中剂量组,但差异无统计学意义(P>0.05)。结论中剂量和高剂量rhGH治疗在提高骨密度、血清IGF⁃1和IGFBP⁃3水平方面更为有效,推荐在确保安全性的前提下,根据男童具体情况选择适当剂量的rhGH进行治疗。Objective To investigate the effects of different doses of recombinant human growth hormone(rhGH)on idiopathic short stature in boys and its impact on serum metabolic biomarkers,insulin⁃like growth factor 1(IGF⁃1),and insulin⁃like growth factor binding protein 3(IGFBP⁃3).Methods Eighty boys with idiopathic short stature who were admitted to Jiangyin Hospital of Traditional Chinese Medicine from April 2020 to April 2023 were enrolled.They were assigned to low⁃dose group(0.26 mg/kg per week,n=29),medium⁃dose group(0.35 mg/kg per week,n=27),and high⁃dose group(0.41 mg/kg per week,n=24)according to the therapeutic dose of rhGH.The treatment lasted for 1⁃2 years.Height,weight,growth velocity,height standard score,bone density,bone age,bone metabolisms(serum 25⁃hydroxyvitamin D[25(OH)⁃D],bone alkaline phosphatase[BAP],and osteocalcin[OC]),thyroid function(free triiodothyronine[FT3],free thyroxine[FT4],and thyroid⁃stimulating hormone[TSH]),IGF⁃1,and IGFBP⁃3 were compared among groups before and after treatment.Results The height,weight,growth velocity,height standard score,bone density,and bone age were increased in all the three groups after treatment(P_(Time)<0.05).Serum 25(OH)⁃D,BAP,and osteocalcin were also significantly increased(P_(Group)<0.05,P_(Time)<0.05).As the treatment progressed,serum IGF⁃1 and IGFBP⁃3 levels increased(P_(Time)<0.05).The incidence of adverse reaction(joint pain,injection site edema,and hyperglycemia)in the high⁃dose group(25.00%)was higher than that in the low⁃dose group(13.79%)and medium⁃dose group(18.52%).Conclusion Medium and high doses of rhGH can more effectively improve bone density,serum IGF⁃1,and IGFBP⁃3 in boys with idiopathic short stature.It is recommended to choose an appropriate dose of rhGH based on the specific condition of boys with idiopathic short stature under the precondition of safety.

关 键 词：特发性矮小症 重组人生长激素 代谢标志物 类胰岛素样生长因子⁃1 类胰岛素样生长因子结合蛋白⁃3 

分 类 号：R97[医药卫生—药品]