摘要
目的:探讨维生素D结合不同剂量重组人生长激素(rhGH)对特发性矮小症(ISS)患儿的治疗效果及血清胰岛素样生长因子结合蛋白3(IGFBP-3)、皮质醇水平和骨龄的影响。方法:选取118例ISS患儿为研究对象,按治疗方法不同将患儿分为高剂量组(n=61)和低剂量组(n=57)。高剂量组给予维生素D+0.2 IU·kg^(-1)·d^(-1)rhGH治疗;低剂量组给予维生素D+0.15 IU·kg^(-1)·d^(-1)rhGH治疗,两组患儿疗程均为1年。比较两组患者治疗前后生长发育情况、血清骨代谢指标、IGFBP-3、皮质醇水平、骨龄指标及治疗期间不良反应。结果:治疗后,两组患儿身高、体重、血清骨钙素(OC)、骨碱性磷酸酶(BALP)、25羟基维生素D[25-(OH)D]、IGFBP-3水平、骨龄指数(BAI)、骨龄年龄差(BDA)均升高(P<0.05),且高剂量组高于低剂量组(P<0.05);身高标准差积分(Ht SDS)、血清皮质醇水平均降低(P<0.05),且高剂量组低于低剂量组(P<0.05)。治疗期间,两组患儿不良反应发生率比较,差异无统计学意义(P>0.05)。结论:维生素D结合高剂量rhGH对ISS患儿治疗效果更佳,且能改善血清IGFBP-3、皮质醇及骨龄水平,值得临床推广应用。
Objective:To explore the therapeutic effect of vitamin D combined with different doses of recombinant human growth hormone(rhGH)on children with idiopathic short stature(ISS)and the influence on serum insulin-like growth factor binding protein 3(IGFBP-3),cortisol and bone age.Methods:118 children with ISS were selected as the research subjects.According to different treatment methods,the children were divided into high-dose group(n=61,vitamin D+0.2 IU/kg/d rhGH)and low-dose group(n=61,vitamin D+0.15 IU/kg/d rhGH).The course of treatment for both groups was 1 year.Growth and development,serum bone metabolism indicators,IGFBP-3,cortisol and bone age indicators before and after treatment and adverse reactions during treatment were compared between the two groups.Results:After treatment,the height,weight,serum levels of osteocalcin(OC),bone alkaline phosphatase(BALP),25 hydroxyvitamin D[25-(OH)D]and IGFBP-3,BAI and BDA in the two groups were increased(P<0.05),and the high-dose group was higher than the low-dose group(P<0.05).The Ht SDS and serum cortisol level were reduced in the two groups(P<0.05),and the high-dose group was lower than the low-dose group(P<0.05).There were no statistical differences in the incidence rates of adverse reactions between the two groups(P>0.05).Conclusion:Vitamin D combined with high-dose rhGH has a therapeutic effect on children with ISS,and it can improve serum IGFBP-3,cortisol and bone age,which is worthy of clinical promotion and application.
作者
邹兰灵
杨麒麟
王彬郦
ZOU Lan-ling;YANG Qi-lin;WANG Bin-li(Department of Endocrinology,the First People's Hospital of Ziyang,Ziyang People's Hospital,Ziyang 641300,Sichuan,China;Department of Oncology,Ziyang People's Hospital,Ziyang 641300,Sichuan,China)
出处
《川北医学院学报》
CAS
2023年第8期1122-1125,共4页
Journal of North Sichuan Medical College
关键词
特发性矮小症
维生素D
重组人生长激素
骨代谢
胰岛素样生长因子结合蛋白3
Idiopathic short stature
Vitamin D
Recombinant human growth hormone
Bone metabolism
Insulin-like growth factor binding protein 3
