青春期前特发性矮身材儿童的生长激素应用剂量研究

Research on the dose of growth hormone in prepubertal children with idiopathic short stature

目的研究重组人生长激素(rhGH)的不同应用剂量对青春期前特发性矮身材(ISS)儿童的临床治疗疗效。方法选取2014年3月-2016年6月于郑州市妇幼保健院接受治疗的68例ISS患儿为研究对象,在经郑州市妇幼保健院伦理委员会通过的情况下,将其按照随机数表分成两组,其中34例采用皮下注射rhGH 0.25mg/(kg·每周)为低剂量组,34例采用皮下注射rhGH 0.40mg/(kg·每周)为高剂量组,治疗疗程均为14个月,对比两组患儿治疗后生长速度(GV)、身高标准差积分(HtSDS)、骨龄以及不良反应的发生率。结果研究发现,两组患儿在治疗前后的身高(cm)(107.4±6.85vs.126.7±7.15)、GV(7.45±1.09vs.11.68±1.37)以及HtSDS(-0.96±0.43vs.-0.64±0.52)等存在明显差异,差异具有统计学意义(P<0.05),两组患儿的骨龄比较,差异无统计学意义(P>0.05);两组患儿出现注射部位红肿、疼痛的例数比较,差异无统计学意义(P>0.05),均可自行消退。结论 rhGH对治疗ISS有显著效果,高剂量rhGH的治疗效果优于低剂量rhGH。

Objective To explore the clinical efficacy of recombinant human growth hormone （rhGH） in children with prepubertal idiopathic short stature （ISS）. Methods A total of 68 children with ISS treated in Zhengzhou Maternal and Child Health Care Hospital from March 2014 to June 2016 were enrolled in this study,and the study was approved by ethics committee unanimously. According to the random number table, the participants were divided into two groups,of which 34 cases were treated with subcutaneous injection of low-dose rhGH 0.25 mg/（kg·week） as the low dose group,the other 34 cases with high-dose subcutaneous injection of rhGH 0.40 mg/（kg·week） as the high dose group,and the course of treat- ment was 14 months. Growth relovity （GV） ,height standard deviation integral （HtSDS） ,bone age and incidence of adverse reactions were compared between the two groups after treatment. Results The differences of height（107.4±6.85 vs. 126.7±7.15）,GV （7.45±1.09 vs. 11.68±1.37）and HtSDS（-0.96±-0.43 vs. -0.64±0.52） index between high dose group and low dose group were significant （P〈0. 05） ;There were no significant differences on bone age,the number of eases of redness and swelling,and pain between the two groups （all P〉0.05） ,and the symptoms counld resolve spontaneously. Conclusion RhGH has significant effect on the treatment of ISS,and the efficacy of high-dose rhGH is better than that of low-dose rhGH.