基因重组人生长激素治疗不同年龄矮小症的效果及对骨代谢、胰岛素样生长因子-1、维生素D3的影响

Efficacy of recombinant human growth hormone in the treatment of dwarfism in children at different ages and its effect on bone metabolism,insulin-like growth factor-1 and vitamin D3

目的:探讨基因重组人生长激素治疗不同年龄矮小症的效果及对患儿骨代谢水平、胰岛素样生长因子-1(IGF-1)、维生素D3的影响。方法:选取2018年1月至2019年1月绍兴市妇女儿童保健院收治的矮小症患儿60例,根据不同年龄分为A组32例,B组28例,A组收治4~9岁患儿,B组收治>9~13岁患儿,两组均采用基因重组人生长激素治疗6个月。记录两组患儿治疗总有效率,于治疗前后检测两组患儿骨代谢指标、IGF-1、25-羟维生素D3等水平。结果:治疗后,A组患儿总有效率为90.62%(29/32),高于B组的67.85%(19/28),差异有统计学意义(χ^(2)=4.838,P<0.05);治疗前两组患儿血钙、磷、锌及血清IGF-1、25-羟维生素D3差异均无统计学意义(均P>0.05);治疗后A组血钙、磷、锌及血清IGF-1、25-羟维生素D3水平分别为(1.99±0.53)mmol/L、(1.76±0.14)mmol/L、(88.97±6.89)μmol/L、(325.57±15.29)ng/L、(89.47±15.58)ng/L,均高于B组的(1.71±0.55)mmol/L、(1.65±0.15)mmol/L、(85.22±6.76)μmol/L、(312.29±13.88)ng/L、(80.11±15.31)ng/L,差异均有统计学意义(t=2.005、2.936、2.121、3.502、2.340,均P<0.05)。结论:基因重组人生长激素对4~9岁矮小症患儿疗效更好,且能有效改善患儿骨代谢水平及IGF-1、维生素D3等指标。

Objective To investigate the effects of recombinant human growth hormone on bone metabolism,insulin-like growth factor-1(IGF-1)and vitamin D3 in dwarfism children at different ages.Methods Sixty children with dwarfism who received treatment in Shaoxing Women's and Children's Health Care Hospital from January 2018 to January 2019 were included in this study.They were divided into group A(age at 4-9 years,n=32)and group B(age at>9-13 years,n=28)according to different ages.Two groups of children were treated with recombinant human growth hormone for 6 months.Total effective rate in two groups was recorded.Before and after treatment,bone metabolism index,serum IGF-1 and 25-hydroxyvitamin D3 levels were measured in each group.Results Total effective rate in the group A was significantly higher than that in the group B[90.62%(29/32)vs.67.85%(19/28),χ^(2)=4.838,P<0.05].Before treatment,there were no significant differences in serum levels of calcium,phosphorus,zinc,IGF-1 and 25 hydroxyvitamin D3 between groups A and B(all P>0.05).After treatment,serum levels of calcium,phosphorus,zinc,IGF-1 and 25 hydroxyvitamin D3 in the group A were(1.99±0.53)mmol/L,(1.76±0.14)mmol/L,(88.97±6.89)μmol/L,(325.57±15.29)ng/L,(89.47±15.58)ng/L,respectively,which were significantly higher than those in the group B[(1.71±0.55)mmol/L,(1.65±0.15)mmol/L,(85.22±6.76)μmol/L,(312.29±13.88)ng/L,(80.11±15.31)ng/L,t=2.005,2.936,2.121,3.502,2.340,all P<0.05].Conclusion Recombinant human growth hormone has better curative effect on dwarfism in children at 4-9 years old than in children at 9-13 years old,and it can effectively improve bone metabolism,IGF-1,vitamin D3 and other indicators.