重组人生长激素治疗垂体性侏儒症对身高骨骼和器官发育的影响

Effects of Recombinant Human Growth Hormone in the Treatment of Disease with Growth Hormone Deficiency

目的 研究国产和进口重组人生长激素 (rhGH)治疗垂体性侏儒症 (生长激素缺乏症 ,GHD)的促身高效应 ,骨龄和肺功能的变化。方法 应用国产rhGH 67例 ,进口 19例。剂量rhGH 0 1IU·Kg-1 ·d-1 ,疗程 6个月 ,使用进口rhGH 19例患者进行 2年的GH疗法 ,第 2年合用绒毛膜促性腺激素或庚酸睾酮 ,了解其 2年中身高年龄增加与骨龄增加的关系。其中 10例在治疗前、治疗后 6个月、12个月进行肺功能的检测。结果 rhGH对这些患儿体格的线性生长有显著促进作用 (P <0 0 0 1) ,国产rhGH治疗 6个月生长速率和进口的相似 (P >0 0 5 )。rhGH 2年疗法的对象 ,患者治疗前、治疗后不同阶段的HA皆和BA呈正相关。 10例观察肺功能的对象 ,肺活量 (VC) ,最大通气量 (MVV)治疗后 12个月均比治疗前明显增加 ( P <0 0 5 )。结论 国产和进口rhGH皆是治疗GHD的有效药物 ,两者的疗效相似。单用rhGH和合用性激素治疗均对GHD有明显的促线性生长作用 ,后者疗效更佳。它们在促身高增加的同时也促骨龄成熟 ,两者平行。rhGH有明显的促器官发育和增加肌力作用 ,身高年龄增加 ,骨龄增加与肺功能改善三者呈平行线性关系。

Objective To evaluate the efficacy of both domestically manufactured and imported recombinant human growth hormone (rhGH) in the treatment of growth hormone deficiency(GHD) disease. Methods 67 patients with GHD were given domestically manufactured rhGH ,while imported rhGH were given to another 19 boys with GHD. The dose of rhGH in both groups was 0 1IU·Kg -1 ·d -1 . 19 boys with GHD received imported rhGH for 24 months in combination with administration of chorionic gonadotropin or Testoviron Depot in second year. Vital Capacity (VC) and Maximal Ventilation Volume(MVV) before and 6,12 months after rhGH treatment were measured in 10 cases. Results The increase in linear growth was significant in both groups. In 19 boys with GHD, HA was direct proportion to BA before and 6,12,18,24 months after treatment. In 10 boys with GHD, 12 months after rhGH treatment, VC and MVV significantly increased as compared with pre-treatment (P<0 05). Conclusions Both domestically and imported rhGH had similar effect in treating GHD. rhGH alone or combined with sex hormone had obvious effect in promoting the growth and development of GHD patients and combination therapy was much better.