来曲唑联合重组人生长激素治疗青春期身材矮小症男性患儿的疗效及对其体格发育、骨代谢的影响

Efficacy of Letrozole Combined with Recombinant Human Growth Hormone in the Treatment of Adolescent Short Stature Boys and Drug Effects on Physical Development and Bone Metabolism

【目的】探讨来曲唑联合重组人生长激素治疗青春期身材矮小症男性患儿的疗效及对其体格发育、骨代谢的影响。【方法】以随机数字表法将本院2021年1月至2022年1月收治的150例青春期身材矮小症男性患儿分为对照组、观察组,每组75例。对照组采用重组人生长激素治疗,观察组采用来曲唑联合重组人生长激素治疗。比较两组治疗前后体格发育指标[身高、体重、生长速度(GV)、身高标准差积分(HtSDS)]、血清骨代谢指标[骨钙素(OC)、骨碱性磷酸酶(BALP)、Ⅰ型前胶原氨基端前肽(PINP)、β-胶原降解产物(β-CTX)]、血清食欲刺激素(Ghrelin)、胰岛素样生长因子结合蛋白-3(IGFBP-3)水平、儿童生活质量核心通用量表(PedsQL)评分、不良反应发生率。【结果】治疗6个月、12个月后,观察组体格发育指标高于对照组(P<0.05);治疗6个月、12个月后,观察组血清骨代谢指标、血清Ghrelin、IGFBP-3水平改善幅度均大于对照组(P<0.05);治疗6个月、12个月后,观察组PedsQL评分高于对照组(P<0.05);观察组不良反应总发生率(9.33%)与对照组(6.67%)相比,差异无统计学意义(P>0.05)。【结论】来曲唑、重组人生长激素联合治疗青春期身材矮小症男性患儿疗效确切,可调节骨代谢指标水平,促进患儿生长、发育,且安全性较高。

【Objective】To study the efficacy of letrozole combined with recombinant human growth hormone in treating boys with pubertal short stature and drug effects on physical development and bone metabolism.【Methods】One hundred and fifty boys with adolescent short stature disorder admitted to the hospital from January 2021 to January 2022 were divided into a control group and a combination group with 75 cases each by the random number table method.The control group was treated with recombinant human growth hormone and the combination group was treated with letrozole combined with recombinant human growth hormone.The physical development indexes[height,weight,growth velocity(GV),height standard deviation score(HtSDS)],serum bone metabolism indexes[osteocalcin(OC),bone alkaline phosphatase(BALP),pre-collagen typeⅠamino-terminal peptide(PINP),β-collagen degradation product(β-CTX)],serum appetite stimulating hormone(Ghrelin),serum insulin-like growth factor binding protein-3(IGFBP-3)levels,core generalized children's quality of life scale(PedsQL)scores,and incidence of adverse reactions were compared between the two groups.【Results】The physical development indexes in the combined group were higher than those in the control group after 6 and 12 months of treatment(P<0.05).After 6 and 12 months of treatment,the improvement of serum bone metabolism indexes and levels of both serum Ghrelin and IGFBP-3 in the combined group were greater than those in the control group(P<0.05).The PedsQL score in the combined group was higher than that in the control group after 6 and 12 months of treatment(P<0.05).The overall incidence of adverse reactions in the combined group was 9.33%and overall incidence of adverse reactions was 6.67%in the control group,which was not statistically significant(P>0.05).【Conclusion】The combination of letrozole and recombinant human growth hormone is effective in treating male children with adolescent short stature disorder,and it can regulate the level of bone metabolic indexes and promote the growth and development of children with high safety.