重组人生长激素联合注射用醋酸亮丙瑞林微球治疗青春期早发育特发性矮身材的效果

Effect of recombinant human growth hormone combined with leuprorelin acetate microspheres for injection in the treatment of early puberty in children with idiopathic short stature

目的观察重组人生长激素(rhGH)联合注射用醋酸亮丙瑞林微球治疗青春期早发育特发性矮身材(ISS)的效果。方法选取2018年7月至2020年7月徐州医科大学附属医院收治的40例青春期早发育ISS患儿作为研究对象,依据患儿家长治疗意愿分为单用rhGH治疗组与联合治疗组,每组20例。单用rhGH治疗组给予rhGH治疗,联合治疗组在单用rhGH治疗组基础上联合注射用醋酸亮丙瑞林微球治疗。比较两组生长情况[骨龄、身高、生长速度(GV)、预测终身高(PAH)、血清胰岛素样生长因子-1(IGF-1)水平]及不良反应发生情况。结果治疗前,两组骨龄、身高、GV、PAH、IGF-1水平比较差异无统计学意义。治疗后,两组骨龄均大于治疗前,身高、PAH、IGF-1水平均高于治疗前,GV快于治疗前,且联合治疗组骨龄低于单用rhGH治疗组,PAH高于单用rhGH治疗组,差异有统计学意义(P<0.05);两组GV、身高、IGF-1水平比较差异无统计学意义。随访第3个月时,两组不良反应发生率比较差异无统计学意义。结论rhGH联合注射用醋酸亮丙瑞林微球治疗青春期早发育ISS患儿能有效加快GV,提高PAH,其疗效优于单用rhGH治疗,治疗后无明显不良反应,值得临床推广应用。

Objective To observe the effect of recombinant human growth hormone(rhGH)combined with leuproerelin acetate microspheres for injection in the treatment of early puberty in children adolescent idiopathic short stature(ISS).Methods A total of 40 early puberty children with ISS who were admitted in the Affiliated Hospital of Xuzhou Medical University from July 2018 to July 2020 were selected as the study subjects,and they were divided into the rhGH alone treatment group and the combined treatment group according to their parents'treatment wishes,with 20 cases in each group.The rhGH treatment group alone was given rhGH treatment,and the combined treatment group was combined with leuprorelin acetate microspheres on the basis of rhGH treatment group alone,the growth conditions(bone age,height,growth velocity[GV],predicted adult height[PAH],serum insulin-like growth factor-1[IGF-1])and the occurrence of adverse reactions were compared between the two groups.Results Be-fore treatment,there were no significant differences in bone age,height,GV,PAH and IGF-1 levels between the two groups;after treatment,bone age of the two groups were greater than before treatment,height,PAH and IGF-1 levels were higher than before treatment,GV were faster than be-fore treatment,the bone age in the combined treatment group was lower than that in the rhGH treatment group alone,and the PAH was higher than that in the rhGH treatment group alone,the differences were statistically significant(P<0.05);there were no significant differences in GV,height and IGF-1 level between the two groups.At the third month of follow-up,there was no significant difference in the incidence of adverse reactions between the two groups.Conclusion rhGH combined with leuprorelin acetate microspheres can effectively improve GV and PAH in the treatment of ISS children with early puberty,and its efficacy is superior to rhGH treatment alone,with no obvious adverse reactions after treatment,which is wor-thy of clinical application.