重组人生长激素治疗特发性矮小症对骨代谢的疗效及安全性

Effect and safety of recombinant human growth hormone on bone metabolism in patients with idiopathic dwarf

目的观察重组人生长激素(rhGH)治疗特发性矮小症的疗效及安全性。方法选择2014年1月-2019年1月该院诊断特发性矮小症的患儿180例为研究对象,均给予皮下注射rh GH[0.123~0.200 U/(kg·d)],治疗周期为2年。治疗过程中,每月记录患儿身高、生长速度(GV)、身高标准差积分(Ht SDS),预测成年身高(PAH)、骨代谢指标[骨钙素(OC)、维生素D],观察骨龄(BA)、血清甲状腺激素(T_(4))、促甲状腺激素(TSH)、游离甲状腺素(FT_(4))、空腹血糖(FPG)、胰岛素样生长因子-1(IGF-1)水平并分析其变化。结果观察指标:患者治疗后GV、HtSDS、PAH及骨代谢指标均较治疗前有所提升,与治疗前比较差异有统计学意义(P<0.05);治疗前后BA差异无统计学意义(P>0.05);生化指标:治疗后T_(4)、FT_(4)及IGF-1水平较治疗前有均所提升,差异有统计学意义(P<0.05);治疗前后FPG、TSH比较差异无统计学意义(P>0.05)。结论采用GH治疗小儿特发矮小,可明显促进OC水平,较好的反应患儿生长速度,是安全、有效的治疗方式。

Objective To observe the efficacy and safety of recombinant human growth hormone(rhGH)in the treatment of idiopathic dwarf.Methods A total of 180 children with idiopathic dwarf diagnosed in our hospital from January 2014 to January 2019 were selected as study subjects.They were given subcutaneous injection of rh GH[0.123-0.200 U/(kg·d)]for a treatment period of 2 years.During the treatment,the children’s height,growth velocity(GV),height standard deviation score(Ht SDS)were recorded monthly,and the prediction of adult height(PAH)was observed.Serum osteocalcin(OC)levels,serum thyroid hormone(T_(4)),thyroid stimulating hormone(TSH),free thyroxine(FT_(4)),fasting blood glucose(FPG),insulin-like growth factor-1(IGF-1)Level and analyze its changes.Results Observation indicators:GV,Ht SDS,PAH,and OC of patients were improved after treatment compared with before treatment,and there was a significant difference compared with before treatment(P<0.05);there was no significant difference in BA before and after treatment(P>0.05)Biochemical indicators:The levels of T_(4),FT_(4),and IGF-1 after treatment were all higher than those before treatment,and the difference was statistically significant(P<0.05);there was no significant difference in FPG and TSH before and after treatment(P>0.05).Conclusion GH therapy can promote bone metabolism in children with idiopathic dwarf,and it is a safe and effective treatment.