赖氨酸磷酸氢钙颗粒联合重组人生长激素对矮小症患儿生长发育的影响

Effects of Lysine Hydrochloride and Calcium Hydrogen Phosphate Granules Combined with Recombinant Human Growth Hormone on Growth and Development of Children with Short Stature

目的:分析赖氨酸磷酸氢钙颗粒联合重组人生长激素对矮小症患儿生长发育的影响。方法:选取2016年1月至2019年1月就诊于承德医学院附属医院的矮小症患儿60例,按完全随机法分为单药A组、单药B组和联合治疗组各20例,另外选取因各种原因未进行临床药物治疗的20例患儿为对照组。单药A组采用重组人生长激素治疗,单药B组采用赖氨酸磷酸氢钙颗粒治疗,联合治疗组采用赖氨酸磷酸氢钙颗粒联合重组人生长激素治疗。比较四组患儿生长发育情况及骨代谢指标骨钙素、骨碱性磷酸酶(BAP)、Ⅰ型胶原交联羧基末端肽(ⅠCTP)、促甲状腺激素(TSH)、胰岛素样生长因子1(IGF-1)、胰岛素样生长因子结合蛋白3(IGF-BP3)、维生素D、血钙、血磷、碱性磷酸酶水平,分析单药A组、单药B组、联合治疗组临床疗效及不良反应发生情况。结果:单药A组、单药B组、联合治疗组垂体磁共振相关参数、生长速率、体质量指数(BMI)、骨钙素、BAP、ⅠCTP、IGF-1、IGF-BP3、维生素D、血钙、血磷、碱性磷酸酶水平高于对照组(P<0.05)。联合治疗组身高、体质量、生长速率、BMI、骨钙素、BAP、ⅠCTP、IGF-1、IGF-BP3、维生素D、血钙、血磷、碱性磷酸酶水平高于单药A组、单药B组(P<0.05)。三组患儿临床疗效比较差异无统计学意义(P>0.05)。结论:赖氨酸磷酸氢钙颗粒联合重组人生长激素用于儿童矮小症疗效理想,可能通过改变垂体发育不良,补充机体维生素D,改善骨代谢异常,发挥其促进生长发育的作用。

Objective: To analyze the effects of lysine hydrochloride and calcium hydrogen phosphate granules combined with recombinant human growth hormone on growth and development of children with short stature. Methods: A total of 60 children with short stature admitted into the Affiliated Hospital of Chengde Medical College from Jan. 2016 to Jan. 2019 were randomly divided into the single drug group A, single drug group B and combined treatment group, with 20 cases in each group. And 20 children that did not receive clinical drugs due to various reasons were selected as the control group. The single drug group A was treated with recombinant human growth hormone, the single drug group B was given lysine hydrochloride and calcium hydrogen phosphate granules, and the combined treatment group received lysine hydrochloride and calcium hydrogen phosphate granules combined with recombinant human growth hormone. Growth and bone metabolism indicators, osteocalcin, bone alkaline phosphatase(BAP), type Ⅰ collagen crosslinked carboxy-terminal peptide(ⅠCTP), thyrotropin(TSH), insulin-like growth factor 1(IGF-1), insulin-like growth factor binding protein 3(IGF-BP3), vitamin D, blood calcium, blood phosphorus and alkaline phosphatase levels of four groups were compared. The clinical efficacy and adverse drug reactions of single drug group A, single drug group B and combined treatment group were analyzed. Results: Pituitary magnetic resonance imaging-related parameters, growth rate, body mass index(BMI), osteocalcin, calcitin, BAP, ⅠCTP, IGF-1, IGF-BP3, vitamin D, blood calcium, blood phosphorus, and alkaline phosphatase levels in the single drug group A, single drug group B and combined treatment group were higher than those in the control group(P<0.05). Height, body weight, growth rate, BMI, osteocalcin, BAP, ⅠCTP, IGF-1, IGF-BP3, vitamin D, blood calcium, blood phosphorus and alkaline phosphatase levels in the combined treatment group were higher than those in the single drug group A and single drug group B(P<0.05). There was no significant difference in clinical efficacy among three groups(P>0.05). Conclusion: The efficacy of lysine hydrochloride and calcium hydrogen phosphate granules combined with recombinant human growth hormone in the treatment of children with short stature is significant, which may play its role in promoting growth and development through changing the pituitary hypoplasia, supplementing the vitamin D and improving the abnormal bone metabolism.