重组人生长激素治疗儿童矮小症的临床疗效观察

Clinical effect of recombinant human growth hormone in treatment of children with short stature

目的探讨重组人生长激素(rhGH)在不同病因矮小症患儿治疗中的临床疗效。方法回顾性分析2015年4月—2017年5月在许昌儿童医院小儿内分泌专科门诊诊断为矮小症患儿98例,其中生长激素缺乏症(GHD)患儿36例,特发性矮小(ISS)患儿54例,宫内发育迟缓(SGA)患儿6例,特纳综合征(TS)患儿2例,rhGH治疗1~2年,观察不同病因矮小症患儿身高变化,年生长速度,骨龄等的差异及不良反应。结果 98例矮小患者治疗后的身高及生长速度较治疗前有明显增长,生长激素的促生长效果明显,第1年身高增长最快,分别达到(11.12±2.46)、(9.63±1.75)、(9.51±1.84)、(8.45±1.83)cm/年。重组人生长激素治疗后骨龄及第二性征无明显变化,患者前后的甲状腺功能、血尿常规均正常。结论重组人生长激素在生长激素缺乏症、特发性矮小、宫内发育迟缓、特纳综合征患儿等矮小患儿治疗中有明显促生长作用,矮小症病因不同,治疗效果有差异。

Objective： To investigate the clinical effect of recombinant human growth hormone（ rhGH） in the treatment of children with different causes in short stature. Methods A retrospective analysis from April 2015 to May 2017 in Xuchang children’s Hospital pediatric endocrine clinic diagnosis of short stature children in 98 cases,including 36 cases of growth hormone deficiency（ GHD） children,54 cases of idiopathic short stature（ ISS）,6 cases of intrauterine growth retardation（ SGA）,2 cases of Turner syndrome（ TS）. After 1 ~ 2 years of treatment with rhGH,differences in height,annual growth rate,bone age and adverse reactions of children with dwarfism of different etiology were observed. Results The height and the growth rate of 98 cases of short stature patients after treatment was significantly higher than that of before treatment,the growth promoting effect of growth hormone was the fastest increase in height in the first years,respectively（ 11. 12 ± 2. 46）,（ 9. 63 ± 1. 75）.（ 9. 51 ± 1. 84）,（ 8. 45 ± 1. 83） cm/year. Recombinant human growth hormone therapy after bone age and sex characteristics have no obvious changes of thyroid function in patients with the blood and urine routine were normal. Conclusion Recombinanthuman growth hormone has obvious growth effect in the treatment of growth hormone deficiency,idiopathic short stature,intrauterine growth retardation,Turner syndrome can promote the growth effect,short stature causes different treatment effect differences.