重组人生长激素治疗儿童生长激素缺乏症和特发性矮小症的临床观察

Clinical observation of recombinant human growth hormone in the treatment of growth hormone deficiency and idiopathic short stature in children

目的观察重组人生长激素(rhGH)在治疗儿童生长激素缺乏症(GHD)和特发性矮小症(ISS)的临床效果、探讨胰岛素样生长因子1(IGF-1)的价值及安全性。方法选择2016年1月至2017年12月宜兴市人民医院收治的GHD患儿12例、ISS患儿7例为研究对象,按诊断分为GHD组和ISS组。给予rhGH水剂进行治疗,每周6～7d,每晚睡前30min予0.1～0.2U/(kg·d)皮下注射。分别检查治疗前、治疗后3个月、6个月患儿身高、计算生长速度及检测IGF-1、计算IGF-1标准差积分。结果 GHD组患儿身高增值、身高增长速率均值均显著高于ISS组,差异有统计学意义(P<0.05);两组IGF-1标准差积分均有明显上升,差异有统计学意义(P<0.05),且GHD组上升幅度较ISS组明显增加。结论 rhGH治疗儿童矮小症有明显的促生长效果,尤其是GHD患儿疗效明显,IGF-1有助于疗效及安全性的评估。

Objective To observe the clinical effect of recombinant human growth hormone(rhGH)in the treatment of growth hormone deficiency(GHD)and idiopathic short stature(ISS)in children,and to explore the value and safety of IGF-1.Methods A total of 12 GHD children and 7 ISS children diagnosed in Yixing People Hospital from January 2016 to December 2017 were chosen as the research subjects and were treated with rhGH.They were divided into GHD group and ISS group according to the diagnosis.Subcutaneous injection of rhGH at 0.1-0.2U/(kg·d)was given30min before going to bed for 6-7 times each week.The growth rate and IGF-1 were measured before treatment,and at 3 months and6months after treatment.The standard deviation integral was calculated,too.Results(1)The average height increase and growth rate in GHD group were significantly higher than those in ISS group,and the difference was statistically significant.(2)The standard deviation integral of IGF-1 in both groups increased significantly,with statistical significance,and the increase in GHD group was significantly higher than that in ISS group.Conclusion RhGH has obvious effect of promoting growth on children with short stature,especially on children with GHD,and IGF-1is helpful for the evaluation of efficacy and safety.