重组人生长激素联合营养支持治疗儿童特发性矮小症的疗效及血清Ghrelin、IGF-1水平变化观察

Efficacy of recombinant human growth hormone combined with nutritional support in treatment of idiopathic short stature in children and observation of changes in serum ghrelin and IGF-1 levels

目的观察重组人生长激素(rhGH)联合营养支持治疗儿童特发性矮小症(ISS)的疗效及血清饥饿激素(Ghrelin)、胰岛素样生长因子-1(IGF-1)的水平变化情况。方法选取2017年6月至2019年5月安阳市妇幼保健院收治的90例ISS儿童作为研究对象,采用抽签法分为观察组和对照组,每组45例。对照组给予营养支持;观察组在对照组基础上予以rhGH治疗。比较两组治疗效果及血清Ghrelin、IGF-1水平。结果两组治疗后身高(Ht)、生长速率(GV)较治疗前升高,且观察组高于对照组(P<0.05)。两组体重(Wt)、骨龄(BA)比较,差异无统计学意义(P>0.05)。两组治疗后血清Ghrelin水平较治疗前低,而IGF-1水平较治疗前高(P<0.05),且观察组血清Ghrelin水平低于对照组,IGF-1水平高于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论rhGH联合营养支持治疗儿童ISS效果较好,能够降低血清Ghrelin水平、升高IGF-1水平,且不良反应较少。

【Objective】To observe the efficacy of recombinant human growth hormone(rhGH)combined with nutritional support in the treatment of idiopathic short stature(ISS)in children and the changes in levels of serum ghrelin and insulin-like growth factor-1(IGF-1).【Methods】Ninety ISS children in our hospital were selected and divided into the control group and the observation group by lottery,with 45 cases in each group.The control group was given nutritional support,and the observation group was given rhGH treatment on the basis of the control group.The treatment effects and levels of serum ghrelin and IGF-1 were compared between the two groups.【Results】After treatment,the height(Ht)and growth velocity(GV)of the two groups were significantly increased(P<0.05),and there were no significant changes in the weight(Wt)and bone age(BA)(P>0.05),and the Ht and GV in the observation group were higher than those in the control group(P<0.05),and the Wt and BA were not significantly different from those in the control group(P>0.05).After treatment,the serum ghrelin level in the two groups was significantly reduced(P<0.05)while the IGF-1 level was significantly increased(P<0.05),and the serum ghrelin level in the observation group was lower than that in the control group(P<0.05)while the IGF-1 level was higher than that in the control group(P<0.05).There was no significant difference in the incidence rate of adverse reactions between the two groups(P>0.05).【Conclusion】rhGH combined with nutritional support is effective in treating children with ISS.It can reduce serum ghrelin level and increase IGF-1 level,and has fewer adverse reactions.