聚乙二醇重组人生长激素对特发性矮小症患儿胰岛素样生长因子-1水平的影响及临床意义

The change and clinical significance of IGF-1 in children with idiopathic short stature treated with PEG-rhGH

目的探究聚乙二醇重组人生长激素(PEG-rhGH)对特发性矮小症患儿胰岛素样生长因子-1(IGF-1)水平的影响及临床意义。方法选取2021年7月—2023年1月在吉林大学中日联谊医院儿科门诊治疗并确诊的44例特发性矮小症患儿为研究对象,采用随机分组方法将研究对象分为观察组19例和对照组25例,观察组接受PEG-rhGH治疗,对照组使用短效的生长激素治疗。比较两组患儿治疗前后身高、IGF-1、甲功三项及血糖的变化情况。结果治疗前,两组患儿身高、IGF-1、甲功三项[游离三碘甲状腺原氨酸(FT3)、甲状腺素(FT4)及促甲状腺激素(TSH)]及血糖水平比较,差异均无统计学意义(P>0.05)。治疗后,两组患儿身高[观察组(128.56±18.77)cm,对照组(132.01±15.55)cm]比较,差异无统计学意义(t=0.668,P>0.05),但观察组IGF-1水平369.10(240.60,402.30)ng/ml高于对照组278.30(230.45,329.95)ng/ml,差异有统计学意义(U=-2.144,P<0.05);各组患儿身高、IGF-1与治疗前相比较,差异均有统计学意义(均P<0.05)。治疗后,两组患儿甲功三项、血糖水平比较,差异均无统计学意义(均P>0.05);各组患儿甲功三项、血糖水平与治疗前比较,差异均无统计学意义(均P>0.05)。结论采用PEG-rhGH治疗的特发性矮小症患儿IGF-1水平高于采用短效生长激素治疗的患儿,提示长效生长激素的疗效更佳,且无明显不良反应。

Objective To investigate the effect of Polyethylene glycol recombinant human growth hormone on IGF-1 in children withidiopathic short stature and its clinical significance.Methods From July 2021 to January 2023,44 children with ISS were treated in Department of Paediatrics,China-Japan Union Hospital of Jilin University,the subjects were randomly divided into experimental group(19 cases)and control group(25 cases),the experimental group received Polyethylene glycol recombinant human growth hormone(PEG-rhGH)and the control group received short-acting growth hormone.The changes of height,insulin-likegrowth factor-1(IGF-1),thyroid function(Free triiodothyronine、Free Thyroxine and Thyroid-stimulating hormone)and blood glucose before and after treatment were compared between the two groups.Results Before treatment,there was no difference in height,IGF-1,thyroid function and blood glucose level between the two groups(P>0.05).After treatment,there was no difference in height between the two groups[experimental group(128.56±18.77)cm,control group(132.01±15.55)cm,t=0.668,P>0.05],but the level of IGF-1 in the experimental group[369.10(240.60,402.30)ng/ml]was higher than that in the control group[278.30(230.45,329.95)ng/ml,U=-2.144,P<0.05],After treatment,there was no significant difference in the three thyroid functions andblood glucose levels between the two groups(P>0.05).Conclusion IGF-1 levels in ISS children treated with Polyethylene glycol recombinant human growth hormone were higher than those treated with short-acting growth hormone,indicating that long-acting growth hormoneis more effective and has no obvious side effects.