摘要
目的分析不同剂量重组人生长激素(r-hGH)治疗对特发性矮小症(ISS)患儿身高、体重以及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)表达的影响。方法回顾性分析2014年3月—2018年4月收治的58例ISS患儿的临床资料。按照r-hGH应用剂量不同分为大剂量组31例[r-hGH 0.2 U/(kg·d)皮下注射]和小剂量组27例[r-hGH 0.1 U/(kg·d)皮下注射]。比较2组治疗前和治疗12个月后生长情况相关指标:身高、体重、生长速度(GV)、身高标准差积分(Ht SDS)水平差异,比较血清IGF-1、IGFBP-3以及骨代谢相关指标:Ⅰ型前胶原氨基端前肽(PⅠNP)、骨碱性磷酸酶(BAP)、Ⅰ型胶原交联羧基末端肽(β-CTX)水平差异,观察不良反应发生情况。结果治疗后,2组身高、体重、GV、Ht SDS以及血清IGF-1、IGFBP-3、PⅠNP、BAP水平均较治疗前明显升高,且大剂量组明显高于小剂量组(P<0.05)。治疗后,2组血清β-CTX水平均较治疗前明显降低,且大剂量组明显低于小剂量组(P<0.05)。2组总不良反应发生率比较差异无统计学意义(P>0.05)。结论大剂量r-hGH更有利于促进ISS患儿生长,改善患儿血清IGF-1、IGFBP-3水平和骨代谢,且安全性良好。
Objective To analyze the effects of different doses of recombinant human growth hormone(r-hGH)on height,weight,and expressions of serum insulin-like growth factor(IGF-1)and insulin-like growth factor binding protein 3(IGFBP-3)in children with idiopathic short stature(ISS).Methods The clinical data of 58 ISS children admitted from March 2014 to April 2018 were retrospectively analyzed.According to different application doses of r-hGH,there were 31 cases in the high-dose group[r-hGH 0.2 U/(kg·d)subcutaneous injection]and 27 cases in the low-dose group[r-hGH 0.1 U/(kg·d)subcutaneous injection].Before and at 12 months after treatment,growth related indicators were compared in the two groups,including height,weight,growth velocity(GV),differences in standard deviation score(Ht SDS),Serum IGF-1,IGFBP-3 and bone metabolism related indicators were compared,including typeⅠprocollagen amino terminal propeptide(PⅠNP),bone alkaline phosphatase(BAP),typeⅠcollagen cross-linked carboxy terminal peptide(β-CTX),and the occurrence of adverse reactions was observed.Results After treatment,the height,weight,GV,HT SDS,IGF-1,IGFBP-3,PⅠNP and BAP levels in the two groups were significantly higher than those before treatment,and those in the high-dose group were significantly higher than those in the low-dose group(P<0.05).After treatment,the level of serumβ-CTX in the two groups was significantly lower than that before treatment,and the level in the high-dose group was significantly lower than that in the low-dose group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion High-dose r-hGH is more conducive to the growth of ISS children,which can improve the level of IGF-1,IGFBP-3 and bone metabolism,and has good safety.
作者
郭艳艳
蒋成霞
姚兰
黄炜
GUO Yan-yan;JIANG Cheng-xia;YAO Lan;HUANG Wei(Department of Endocrinology,the Second People's Hospital of Yibin,Yibin,Sichuan 644000,China;Department of Endocrinology,Affiliated Hospital of Southwest Medical University,Luzhou,Sichuan 646000,China)
出处
《解放军医药杂志》
CAS
2020年第3期44-47,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
国家自然科学青年科学基金(81800741)。
