不同剂量重组人生长激素对特发性矮小症患儿血清IGF-1和IGFBP-3表达的影响

Effects of Different Doses of Recombinant Human Growth Hormone on the Expression of Serum IGF-1 and IGFBP-3 in Children with Idiopathic Short Stature

目的:探讨不同剂量重组人生长激素(rhGH)对特发性矮小症(ISS)患儿血清类胰岛素一号生长因子(IGF-1)和重组人胰岛素样生长因子结合蛋白-3(IGFBP-3)表达的影响。方法:以随机抽签法将2019年11月-2020年12月抚州市第一人民医院收治的90例ISS患儿分为三组(低、中、高剂量组),每组30例。三组均给予常规基础治疗,低、中、高剂量组分别给予皮下注射剂量为0.26、0.35、0.41 mg/kg的rhGH治疗,均连续治疗1年。比较三组治疗前和治疗1年后的生长发育相关指标[身高(Ht)、生长速率(GV)、身高标准差积分(HtSDS)、骨龄]和激素类指标(IGF-1、IGFBP-3)水平,评估三组不良反应发生率。结果:治疗前三组Ht、GV、HtSDS、骨龄比较,差异均无统计学意义(P>0.05);治疗1年后,三组Ht、GV、HtSDS、骨龄比较,差异均有统计学意义(P<0.05);治疗1年后,与低、中剂量组比较,高剂量组Ht、GV、HtSDS、骨龄均明显较优,且中剂量组的GV优于低剂量组(P<0.05)。治疗1年后,高剂量组IGF-1、IGFBP-3水平均高于中、低剂量组(P<0.05)。低、中、高剂量组不良反应发生率分别为6.67%、10.00%、16.67%,三组比较,差异无统计学意义(P>0.05)。结论:与低、中剂量rhGH相比较,给予ISS患儿高剂量rhGH治疗,更能有效促进患儿的生长发育,提高其血清IGF-1、IGFBP-3表达水平,且高剂量rhGH不会增加不良反应发生率,具有较高的安全性。

Objective:To investigate the effects of different doses of Recombinant Human Growth Hormone(rhGH)on the expression of serum insulin-like growth factor-1(IGF-1)and insulin-like growth factor-binding protein-3(IGFBP-3)in children with idiopathic short stature(ISS).Method:A total of 90 children with ISS who were admitted to First People's Hospital of Fuzhou from November 2019 to December 2020 were divided into three groups(low,medium and high dose group),according to random drawing of lots,with 30 cases in each group.All the three groups were given routine basic treatment,and the low,medium and high dose group were respectively given rhGH with subcutaneous injection doses of 0.26,0.35,0.41 mg/kg,and they were all treated continuously for one year.The levels of growth-related indicators[height(Ht),growth velocity(GV),height standard deviation score(HtSDS)and bone age]and hormone indicators(IGF-1,IGFBP-3)were compared before and after treatment for one year,and the incidence of adverse reactions in the three groups were evaluated.Result:There were no significant differences in Ht,GV,HtSDS and bone age among the three groups before treatment(P>0.05).After treatment for one year,there were significant differences in Ht,GV,HtSDS and bone age among the three groups(P<0.05).After treatment for one year,compared with the low and middle dose group,Ht,GV,HtSDS and bone age in the high dose group were obviously better,and GV in the middle dose group was better than that in the low dose group(P<0.05).After treatment for one year,the levels of IGF-1 and IGFBP-3 in the high dose group were higher than those in the middle and low dose group(P<0.05).The incidence of adverse reactions in low,medium and high dose group respectively were 6.67%,10.00%and 16.67%,there was no statistical difference among the three groups(P>0.05).