重组人生长激素治疗小于胎龄儿矮小症患儿的临床研究及小于胎龄儿群体身高生长情况

Clinical studies of recombinant human growth hormone therapy of small for gestational age children with short stature height growth analysis and SGA groups

【目的】探讨重组人生长激素(recombinant human growth hormone,rhGH)治疗小于胎龄儿(small for ges-tational age,SGA)矮小症患儿临床价值及合适的疗程,比较SGA群体身高生长与正常群体的差异情况。【方法】2009年12月开始对2000-2006年期间出生的88例SGA矮小症患儿分成治疗组(n=34)、对照组(n=54),治疗组给药rhGH治疗,并分别对6月、1年、1.5年、2年不同疗程下,身高增长的疗效观察。并对所有该期间出生的所有526例SGA进行为期两年的身高增长情况监测。【结果】经两年观察治疗组31例出现有效追赶生长,有效率达91.2%,对照组仅5例出现追赶生长,有效率为9.3%(P<0.01)。rhGH在不同疗程下的疗效在总体上有差异(P<0.01),除1.5年疗程和2年疗程的病例的疗效经统计学检测差异无统计学意义(P=0.45),其余任何不同疗程组之间的疗效差异有统计学意义(P<0.05)。整个SGA群体身高增长特点,除外rhGH治疗影响后,大部分个体均按原来的生长曲线轨迹生长,SGA群体身高与正常人群相比明显偏矮。【结论】rhGH治疗能有效促进SGA矮小症患儿加速长高,在治疗剂量为0.15U/(kg.d)[0.35mg/(kg.周)]下,控制在1.5年疗程费用与获益比最高。SGA整个群体身高与正常人群相比明显偏矮,经两年的监测这一趋势特点随着时间推移不能自行扭转。

[Objective] To investigate the clinical value of small for gestational age （SGA） children with short stature rhGH treatment and the appropriate course of treatment, comparing SGA groups height growth and normal groups differ- ences. [Methods] A total of 526 children of SGA born from 2000 to 2006 were observed,and 88 cases of SGA children with short stature were divided into treatment group with 34 children and control group with 54 children, rhGH treatment was administered in the treatment group. And the efficacy of height growth during 6 months, 1 year, 1.5 years,2 years were compared. All of 526 SGA children＇s height growth were being monitored for two years. [Results] After two years ob- served,3] cases （91.2o/00） of treatment group had an effective catch-up growth,however,only 5 cases （9.3o//00） of control group had an effective catch-up growth （P^0.01）. RhGH efficacy of different treatment period was different （P（0.01）. But there was no statistically significant differences （P=0.45） compared with 1.5 years treatment and 2 years treatment. Height growth characteristics of the entire SGA groups, except for the impact of rhGH treatment, most individuals were car- ried at the growth of the growth curve trajectory height compared to the normal population of the SGA groups obviously partial short. [Conclusions] RhGH treatment can effectively promote SGA children with short stature accelerated height growth,the treatment costs and benefit were the highest at therapeutic doses days 0.15 U/kg with the 1.5 years treatment. SGA height of the entire group compared to the normal was population obviously partial short, trends was unable to reverse over time after two years of monitoring .