从循证医学证据看生长激素促生长治疗的收益及风险

Benefits and risks of growth hormone therapy based on evidence-based medicine

基因重组人生长激素(rhGH)自1985年上市以来,已经治疗了上百万矮身材患儿,适应证不断扩大。同时,超适应证用药及单纯为增高而用药的现象也越来越严重。为此,多个学术组织出台指南或共识期望规范rhGH的诊疗。rhGH治疗生长激素缺乏症(growth hormone deficiency,GHD)终身高获益最大,其他非GHD疾病包括特发性矮小、特纳综合征等应用rhGH促生长收益有限。rhGH长期应用的安全性尚存有争议,临床医生处方rhGH时应谨慎,做到规范化使用。

Since the recombinant human growth hormone(rh GH)was launched in 1985,it has been used to treat millions of children with short stature,and its indications have continued to expand.However,the phenomenon of off-label use and the use solely for increasing height is becoming more and more serious.Because of this,many academic groups have issued guidelines or consensus,hoping to standardize the application of rhGH.The final height benefit of rh GH treatment for GHD is the greatest.In other non-GHD diseases,including idiopathic short stature,Turner syndrome,etc.,the application of rh GH to promote growth has limited benefits.The safety of long-term use of rh GH is still controversial.Clinicians should be cautious when prescribing rhGH and use it in a standardized manner.