碳酸钙D_(3)联合重组人生长激素对身材矮小症患儿生长发育的影响

Effects of calcium carbonate D_(3)combined with recombinant human growth hormone on growth and development in children with short stature

目的探究碳酸钙D_(3)联合重组人生长激素对身材矮小症患儿生长发育的影响。方法选取2018年6月至2021年11月于西部战区总医院就诊的身材矮小症患儿114例。采用随机信封法分为对照组和观察组,各57例。对照组给予重组人生长激素注射液皮下注射治疗,观察组在对照组的基础上联合碳酸钙D_(3)片口服治疗。2组患儿均连续治疗12个月。比较2组患儿治疗前后生长发育情况、骨代谢指标、生长因子水平及甲状腺功能,比较2组治疗期间不良反应总发生率。结果治疗后2组患儿身高、骨龄指数、骨龄年龄差水平均明显高于治疗前,且观察组明显高于对照组[(122±7)cm比(118±7)cm、(0.98±0.02)比(0.97±0.03)、(-0.36±0.05)比(-0.40±0.08)],差异均有统计学意义(均P<0.05)。治疗后观察组骨碱性磷酸酶、Ⅰ型原胶原氨基端前肽、25-羟基维生素D、胰岛素样生长因子1、胰岛素样生长因子结合蛋白3水平均明显高于对照组,食欲刺激素水平低于对照组,差异均有统计学意义(均P<0.05)。治疗后2组患儿促甲状腺激素、游离三碘甲腺原氨酸、游离甲状腺素水平差异均无统计学意义(均P>0.05)。2组患儿不良反应总发生率差异无统计学意义(P>0.05)。结论碳酸钙D_(3)联合重组人生长激素可有效改善各类生长因子分泌水平,提升患儿骨质代谢水平,进而促进患儿生长发育,且对患儿甲状腺功能无明显影响,具有较好的安全性。

Objective To explore the effects of calcium carbonate D_(3)combined with recombinant human growth hormone on growth and development in children with short stature.Methods Totally 114 children with short stature admitted to Western Theater Command General Hospital from June 2018 to November 2021 were selected and divided into observation group and control group by the random envelope method,with 57 cases in each group.The control group was treated with recombinant human growth hormone subcutaneously,and the observation group was combined with calcium carbonate D_(3)orally on the basis of the control group.Both groups were treated for 12 months.Growth and development,bone metabolism indexes,growth factors and thyroid function were compared between the two groups before and after treatment,and the total incidence of adverse reactions in the two groups during treatment were recorded.Results After treatment,the height,bone age index,and bone age difference of both the two groups were significantly higher than those before treatment,and the observation group was significantly higher than the control group[(122±7)cm vs(118±7)cm,(0.98±0.02)vs(0.97±0.03),(-0.36±0.05)vs(-0.40±0.08)](all P<0.05).After treatment,the levels of bone alkaline phosphatase,amino-terminal propeptide of typeⅠprocollagen,25-hydroxy vitamin D,insulin-like growth factor-1 and insulin-like growth factor binding protein-3 in the observation group were significantly higher than those in the control group,and the level of Ghrelin was lower than that in the control group(all P<0.05).After treatment,there were no significant differences in levels of thyroid stimulating hormone,free triiodothyronine,free thyroxine between the two groups(all P>0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusions Calcium carbonate D_(3)combined with recombinant human growth hormone can effectively improve the secretions of various growth factors and enhance the bone metabolism,thereby promote the growth and development of children,it has no significant effect on the thyroid function of children and has a good safety.