重组人生长激素治疗对生长激素缺乏症患儿甲状腺功能的影响及其临床意义

Effect of rhGH on thyroid function and its clinical significance in children with growth hormone deficiency

目的探讨国产重组人生长激素(rhGH)短期替代治疗对生长激素缺乏症(GHD)患儿甲状腺功能的影响及其临床意义,为进一步指导临床治疗提供依据。方法 72例甲状腺功能正常的GHD患儿,分别于rhGH治疗前及治疗3、6个月检测血清FT3、FT4、TSH,并由专人用同一量具测量身高、体重,计算生长速率(GV)和身高标准差积分(HtSDS),观察治疗前后甲状腺激素水平的变化及其与临床指标的关系。结果 1)治疗3、6个月后FT3水平、FT3/FT4比值较治疗前均显著升高(P<0.05),而FT4、TSH水平,与治疗前相比,差异均无统计学意义(P>0.05)。2)治疗3、6个月后Ht、HtSDS、GV均较治疗前显著增加(P<0.001)。3)治疗前后整体的FT3、FT3/FT4比值与GV、HtSDS均呈显著的正相关(P<0.05)。结论 rhGH治疗会影响甲状腺激素的代谢,血清FT3水平的升高可能有助于促进GHD患儿追赶生长。

Objective To explore the short-term effect of China-made recombinant human growth hormone（rhGH）administration on thyroid function in children with growth hormone deficiency（GHD）and its clinical significance. Methods Totally 72 euthyroid children of GHD underwent rhGH replacement therapy.Serum FT3,FT4,TSH were separately assessed before and after 3,6months of treatment.The height and body mass were measured by the same measuring tool,and then the growth velocity（GV）and the height standard deviation score（HtSDS）were calculated.The changes of thyroid hormone levels and its correlation with clinical index were observed before and after treatment. Results 1）The levels of FT3 and FT3/FT4 ratios both showed statistically significant increases at 3and 6months after treatment（P〈0.05）,however,compared with before treatment,the differences of FT4 and TSH levels were both not statistically significant（P〈0.05）.2）At 3and 6months after treatment,Ht,HtSDS,GV were significantly higher than those of before treatment（P〈0.001）.3）The entire level of FT3 and FT3/FT4 ratios were both positively correlated with GV and HtSDS before and after treatment（P〈0.05）. Conclusion The rhGH administration affects the peripheral thyroid hormone metabolism,and the increase of serum FT3 level may contribute to the growth of GHD children.