Effects of different doses of long-acting growth hormone in treating children with growth hormone deficiency

BACKGROUND With the improvement of economy and living standards,the attention paid to short stature in children has been increasingly highlighted.Numerous causes can lead to short stature in children,among which growth hormone deficiency(GHD)is a significant factor.AIM To investigate the long-term efficacy and safety of different doses of long-acting polyethylene glycol recombinant human growth hormone(PEG-rhGH)in the treatment of GHD in children.METHODS We selected 44 pediatric patients diagnosed with GHD who were treated at Wuhu First People's Hospital from 2014 to 2018.Total 23 patients were administered a high dose of long-acting PEG-rhGH at 0.2 mg/kg subcutaneously each week,forming the high-dose group.Meanwhile,21 patients were given a lower dose of long-acting PEG-rhGH at 0.14 mg/kg subcutaneously each week,establishing the low-dose Group.The total treatment period was 2 years,during which we monitored the patients’height,annual growth velocity(GV),height standard deviation score(HtSDS),chronological age(CA),bone age(BA),and serum levels of insulin-like growth factor-1(IGF-1)and insulin-like growth factor-binding protein-3(IGFBP-3)before treatment and at 6 mo,1 year,and 2 years after treatment initiation.We also monitored thyroid function,fasting plasma glucose,fasting insulin,and other side effects.Furthermore,we calculated the homeostatic model assessment for insulin resistance.RESULTS After 1 year of treatment,the GV,HtSDS,IGF-1,BA,and IGFBP-3 in both groups significantly improved compared to the pre-treatment levels(P<0.05).Moreover,when comparing GV,HtSDS,IGF-1,BA,and IGFBP-3 between the two groups,there were no statistically significant differences either before or after the treatment(P>0.05).During the treatment intervals of 0-1.0 years and 1.0-2.0 years,both patient groups experienced a slowdown in GV and a decline in HtSDS improvement(P<0.05).CONCLUSION The use of PEG-rhGH in treating GHD patients was confirmed to be effective,with similar outcomes observed in both the high-dose group and low-dose groups,and no significant differences in the main side effects.

Effects of recombinant human growth hormone on intestinal translocation of bacteria and endotoxin in rats with obstructive jaundice

Extrahepatic biliary obstruction promotes intestinal translocation of bacteria and endotoxin and this process is an important cause of morbidity and mortality in patients with jaundice. This study was undertaken to investigate the effect and mechanism of recombinant human growth hormone (rhGH) and to alleviate intestinal translocation of bacteria and endotoxin in murine obstructive jaundice. METHODS:A group of 42 Wistar rats were divided into 3 groups:sham operation (SO), bile duct ligation (BDL), and BDL and rhGH treatment (rhGH). By the end of the experiment,on day 7, the animals were killed, and their liver function and serum endotoxin were measured, bacterial cultures of the liver, kidney and mesenchymal lymph were made. Terminal ileum mucosa was observed under an electron microscope. RESULTS:Liver function was improved more significantly in the rhGH group than in the BDL group. The value of endotoxin in the rhGH group was 0.38±0.03 EU/ml, significantly lower than that in the BDL group (0.65±0.04 EU/ml, P【0.01), and similar to that in the SO group (0.30±0.02 EU/ml, P】0.05). The rate of bacteria translocation in the liver, kidney and mesenteric lymph was much higher in the BDL group than in other two groups. The rate of bacteria translocation in mesenteric lymph was 64.29%,significantly higher than that in the SO group and the rhGH group (P【0.05). There was no significant difference in bacteria translocation rate between the SO group and the rhGH group (P】0.05). Under an electron microscope , ileum mucosa epithelial cells in the BDL group were necrotic, and organelle were markedly metamorphic. In the rhGH group, ultrastructural changes were less evident or similar to those in the SO group. CONCLUSION:rhGH has significant protective effects on intestinal mucosa barrier in obstructive jaundice, and reduces intestinal translocation of bacteria and endotoxin.

Altered Nutrition State in the Severe Multiple Trauma Patients Undergoing Adjuvant Recombinant Human Growth Hormone Nutritional Support Therapy

In order to observe the nutrition state in the severe multiple trauma patients undergoing adjuvant recombinant human growth hormone (rhGH) nutritional support therapy, 45 patients with severe multiple traumas (ISS>25) were randomly divided into 3 groups. All the 3 groups had been supplied with nitrogen and caloricity according to the need of patients for 16 days. The rhGH therapy started 48 h after surgery and lasted for 14 days in two rhGH-treated groups in which rhGH was 0.2 and 0.4 U/(kg·d) respectively, and the resting group served as control one. The levels of nitrogen balance, prealbumin and safety variables (blood sugar, Na+, TT3 and TT4) were observed and com- pared among the three groups. The levels of nitrogen balance on the postoperative day (POD) 3 and 5 in the rhGH-treated groups were -1.28±3.19, 5.45±2.00 and -0.18±2.55, 6.11±1.60, respectively, which were significantly higher than those in the control group (-5.17±1.68 and -1.08±3.31, P<0.01). The values of prealbumin on the POD 3 and 5 in the rhGH-treated groups were 180.19±27.15, 194.44±50.82 and 194.94±29.65, 194.11±16.17, respectively, which were significantly higher than those in the control group (117.42±19.10 and 135.63±28.31, P<0.01). There was no sig- nificant difference between the rhGH 0.2 U/(kg·d) group and rhGH 0.4 U/(kg·d) group in both of the levels of nitrogen balance and prealbumin. It is concluded that the nutritional support therapy with adjuvant rhGH which starts 48 h after surgery improves the nutrition state of the patients with severe multiple trauma. It is safe for severe multiple trauma patients who accept rhGH at the dose of 0.2 and 0.4 U/(kg·d).

Effects of recombinant human growth hormone on enterocutaneous fistula patients

AIM： To explore the effects of recombinant human growth hormone （rhGH） on intestinal mucosal epithelial cell proliferation and nutritional status in patients with enterocutaneous fistula. METHODS： Eight patients with enterocutaneous fistulas received recombinant human growth hormone （10 ug/d） for 7 d. Image analysis and immunohistochemical techniques were used to analyse the expression of proliferating cell nuclear antigen （PCNA） in intestinal mucosal epithelial cells in biopsy samples from the patients who had undergone an endoscopic biopsy through the fistula at day 0, 4 and 7. Body weights, nitrogen excretion, serum levels of total proteins, albumin, prealbumin, transferrin and fibronectin were measured at day 0, 4 and 7. RESULTS： Significant improvements occurred in the expression of PCNA in the intestinal mucosal epithelial cells at day 4 and 7 compared to day 0 （24.93 ± 3.41%, 30.46 ± 5.24% vs 12.92 ± 4.20%, p 〈 0.01）. These changes were accompanied by the significant improvement of villus height （500.54 ± 53.79 um, 459.03 ± 88.98um vs 210.94 ± 49.16 um, P 〈 0.01）, serum levels of total proteins （70.52 ± 5.13 g/L, 74.89 ± 5.16 g/L vs 63.51 ± 2.47 g/L, P 〈 0.01）, albumin （39.44 ± 1.18 g/L, 42.39 ± 1.68 g/L vs 35.74 ± 1.75 g/L, P 〈 0.01） and fibronectin （236.3 4- 16.5 mg/L, 275.8± 16.9 mg/L vs 172.5 ± 21.4 mg/L, P 〈 0.01） at day 4 and 7, and prealbumin （286.38 ± 65.61 mg/L vs 180.88 ± 48.28 mg/L, P 〈 0.05）, transferrin （2.61 ± 0.12 g/L vs 2.41 ±0.14 g/L, P 〈 0.05） at day 7. Nitrogen excretion was significantly decreased at day 7 （3.40 ± 1.65 g/d vs 7.25 ± 3.92 g/d, P 〈 0.05）. No change was observed in the body weight. CONCLUSION： Recombinant human growth hormone could promote intestinal mucosal epithelial cell proliferation and protein synthesis in patients with enterocutaneous fistula.

Experimental study on effect of recombinant human growth hormone combined with chemotherapy on stomach neoplasms implanted in nude mice

Objective: To investigate the effect of different doses of recombined growth hormone (rhGH) on stomach neo- plasms implanted in nude mice, and its efficacy in combining with chemotherapy (flurouracil, 5-FU). Methods: Human stom- ach neoplasms model was established in nude mice. The nude mice were divided into control group, moderate-dose of rhGH group, low-dose rhGH group, 5-FU group, moderate-dose rhGH/5-FU group, and low-dose rhGH/5-FU group. The results of each group were observed after ten days. Results: After therapy, the body mass of rhGH groups was significantly increased compared with control group (P<0.05), the body mass of rhGH/5-FU groups was significantly increased compared with 5-FU group (P<0.05), but it was no significant difference between rhGH/5-FU groups and control group (P>0.05). The average tumor mass and volume of rhGH groups were not significantly increased compared with control group (P>0.05), but they were significantly reduced in 5-FU group and rhGH/5-FU groups (P<0.05). They were no significant difference between rhGH/5- FU groups and 5-FU group (P>0.05). After treatment, the percentages of S, G0/G1 and G2/M phases and proliferation index (PI) were not significantly changed in rhGH groups compared with control group (P>0.05), and the same with rhGH/5-FU groups compared with 5-FU group (P>0.05). The difference caused by dose of rhGH was not significant. Conclusion: rhGH enhances body mass, does not stimulate tumor growth, and has no adverse effects on tumor bearing nude mice. Combined with flurouracil, rhGH does not influence the efficacy of chemotherapy, and has no effect on tumor cell cycle kinetics.

Protective effect of perioperative recombinant human growth hormone application on intestinal mucosal barrier function in patients with intestinal obstruction and the assessment of immune inflammatory response

Objective:To study the protective effect of perioperative recombinant human growth hormone (r-hGH) application on intestinal mucosal barrier function in patients with intestinal obstruction and the influence on the immune inflammatory response.Methods:60 patients with intestinal obstruction who underwent surgical treatment in our hospital between February 2013 and July 2016 were selected as the research subjects and divided into the control group (n=34) who received conventional surgical treatment and the observation group (n=26) who received surgery combined with perioperative r-hGH treatment. The serum levels of intestinal mucosal barrier indexes, immunoglobulin and inflammatory response indicators were compared between two groups of patients before and after treatment.Results: Before treatment, differences in serum levels of intestinal mucosal barrier indexes, immunoglobulin and inflammatory response indicators were not statistically significant between the two groups of patients. After treatment, serum intestinal mucosal barrier indexes Endotoxin, D-Lactate and DAO levels in observation group were lower than those in control group, immunoglobulin IgA, IgM and IgG levels were higher than those in control group, and inflammatory response indicators IL-1, IL-6, PCT and TNF-α levels were lower than those in control group patients. Conclusion:Perioperative r-hGH application in patients with intestinal obstruction can protect the intestinal mucosal barrier, also optimize the humoral immunity and suppress the systemic inflammatory response.

Improved Cardiac Contractility of Human Recombinant Growth Hormone on the Congestive Heart Failure of Pig

The enhanced cardiac contractility effect of human recombinant growth hormone (hr-GH) on the congestive heart failure (CHF) was studied on the pig. To build a pig model of congestive heart failure, a temporary artificial cardiac pacemaker was implanted in the pig’s body and paced at 220 beats to 240 beats per minute for 1 week. After the model of congestive heart failure was successfully set up, the frequency of the pacemaker was changed to 150 beats to 180 beats per minute to maintain the CHF model stable. Pigs were divided into three groups: The hr-GH group in which 0.5 mg/kg per day of hr-GH was administrated intramuscularly for 15 days, the injection control group in which an equal amount of physiological saline was injected intramuscularly, and a normal control group. The left ventricular diastolic end pressure was (10.60±2.41) mmHg in the hr-GH group, but (19.00±3.81) mmHg in the saline control group (P<0.01); Cardiac output was (1.86±0.13) L/min in the hr-GH group, but (1.56±0.18) L/min in the saline control group (P<0.05); Peripheral vascular resistance was (56.88±7.51) mmHg·(L/min) -1 in the hr-GH group, whereas (70.30±11.59) mmHg·(L/min) -1 in the saline control group (P<0.05); +dp/dt max was (2900±316.23) and (2280±286.36) in the hr-HG group and the saline control group respectively (P<0.05). The results show that hr-GH enhances myocardial contractility of CHF, and the CHF model built by a temporary artificial cardiac pacemaker at a high rate of stimulation is reasonable and applicable.

Growth-Promoting Effect of Recombinant Human Growth Hormone and Stanozolol in Girls with Turner Syndrome

Summary: Ten girls with Turner syndrome were treated with a combination therapy of recombinant human growth hormone (R hGH) and low dose stanozolol for a period of 8 to 36 months. The results showed that when compared with the growth rate before the treatment, the growth rates after treatment with R hGH and stanozolol showed a sustained increase, reaching 9.0±1.9 cm/year during the first year of treatment; the height age increase by 2.5±0.8 years while the bone age increase were 1.0±0.7 years; and the predicted final adult height at the end of the first year of the treatment increased to 149.4±6.1 cm compared to their original mean of 142.8±4.2 cm. We are led to conclude that therapy with R hGH in combination with stanozolol can increase the growth velocity and significantly increase the predicted adult height of children with Turner syndrome.

Effects of Recombinant Human Growth Hormone on Corneal Healing, Epithelial Nerve Regeneration and Tear Inflammatory Factors in Rabbits

Objective:The goal of this study is to investigate the effects of recombinant human growth hormone(rh GH)on corneal healing,epithelial nerve regeneration and tear inflammatory factor levels in rabbits.Methods:After corneal epithelial injury models were established,fifty adult clean New Zealand white rabbits were randomly divided into two groups,normal saline was administered to the control group,while recombinant human growth hormone was administered to the observation group.The healing rate of corneal epithelial injury,the regeneration ability of corneal epithelial nerve and the level of inflammatory factors in tears were observed and compared between the two groups of rabbits before and 24,48,72 and 96 h after modeling.Results:There were significant differences in corneal epithelial healing rate,time and interaction between the two groups(P<0.05).The experimental group exhibited a superior healing rate of corneal epithelium at 24,48,72,and 96 h compared to the control group(P<0.05).There were significant differences in central cornea sensitivity between the two groups,along with variations in time and interaction(P<0.05).There was no significant difference in the central corneal sensitivity between the two groups before modeling and at 24,72 and 96 h after modeling(P>0.05),whereas the experimental group exhibited a higher central corneal sensitivity compared to the control group at 48 h after modeling(P<0.05).There were significant differences in IL-1α,TNF-α,IL-17a and IL-21 between the two groups(P<0.05).There were significant differences in IL-17a and IL-21 between the two groups(P<0.05).The experimental group exhibited a significant decrease in IL-1αlevels compared to the control group between 24 and 72 h after modeling(P<0.05),the experimental group exhibited a substantial increase in IL-17a levels compared to the control group at 72 h after modeling(P<0.05),and the level of TNF-αin the experimental group was significantly lower than that of the control group between 24 and 96 h after modeling.Conclusion:Recombinant human growth hormone aids in expediting the healing process of the healing of rabbit corneal epithelial injury,facilitating the restoration of epithelial nerve,and mitigating the inflammatory response.

Changes in Serum Leptin Levels during r-hGH Treatment in Growth Hormone-Deficient Children

To observe the effect of growth hormone on serum leptin levels, serum leptin concentrations were measured by enzyme immunoassay in 12 prebutal children with growth hormone deficiency 1, 3 and 6 months before and after the treatment with recombinant human growth hormone (r hGH). For comparison, 34 normal prepubertal children were also investigated. Relationship between leptin levels and body mass index (BMI) was observed at the same time. Our results showed that serum leptin level in normal prepubertal children was 1.22±0.34 ng/ml; the pretreatment serun leptin levels in GHD children was 3.08±2.41 ng/ml, which was significantly different from those 1, 3 and 6 months after GH treatment (i.e. 1.64±1.37 ng/ml,1.57±1.40 ng/ml and 1.35±0.89 ng/ml respectively) (all P <0.001). Our results suggested that r hGH has a suppressive effect on leptin expression.

Optimizing growth in pediatric renal transplant recipients: An update

Growth retardation is a significant complication observed in pediatric renal transplant recipients,originating from a multifactorial etiology.Factors contributing to growth impairment encompass pre-transplant conditions such as primary kidney disease,malnutrition,quality of care,growth deficits at the time of transplantation,dialysis adequacy,and the use of recombinant human growth hormone.Additionally,elements related to the renal transplant itself,such as living donors,corticosteroid usage,and graft functioning,further compound the challenge.Although renal transplantation is the preferred renal replacement therapy,its impact on achieving final height and normal growth in children remains uncertain.The consequences of growth delay extend beyond the physi-ological realm,negatively influencing the quality of life and social conditions of pediatric renal transplant recipients,and ultimately affecting their educational and employment outcomes.Despite advancements in graft survival rates,growth retardation remains a formidable clinical concern among children undergoing renal transplantation.Major risk factors for delayed final adult height include young age at transplantation,pre-existing short stature,and the use of specific immunosuppressive drugs,particularly steroids.Effective management of growth retardation necessitates early intervention,commencing even before transplantation.Strategies involving the administration of recombinant growth hormone both pre-and post-transplant,along with protocols aimed at minimizing steroid usage,are important for achieving catch-up growth.This review provides a comprehensive outline of the multifaceted nature of growth retardation in pediatric renal transplant recipients,emphasizing the importance of early and targeted interventions to mitigate its impact on the long-term well-being of these children from birth to adolescence.INTRODUCTION Children with chronic kidney disease(CKD)endure frequent hospitalizations and ongoing treatment,which significantly affect their quality of life.One of the most noticeable effects of CKD in children is poor growth,with stunted height being a common sign of chronic malnutrition.Growth assessment involves regularly measuring weight and height/length and comparing these against z-score charts,along with other anthropometric indicators like head circumference and mid-upper arm circumference.Data from the North American Pediatric Renal Trials and Collaborative Studies(NAPRTCS)registry shows that over 35%of children enrolled had stunted growth at the time of admission,with growth impairment being more severe in younger children(58%in those aged under 1 year,compared to 22%in those aged over 12 years).Additionally,the same data revealed that growth impairment worsens as the severity of the disease increases.Although recent advances in science have enabled better outcomes for children with CKD,in resource-limited settings,numerous children are still deprived of achieving optimal growth owing to the disease and its related factors.Stunting is a key indicator of chronic growth impairment in children.A study by Wong et al[1]in the United States Renal Data System found that each SD decrease in height among children with stage V CKD is linked to a 14%increase in the risk of death[1].Similarly,research by Furth et al[2]using data from the NAPRTCS indicated that children with a height standard deviation score(SDS)of-2.5 face a relative hazard of death of 2.07.Stunting also correlates with increased hospitalizations.A study in the United States followed 1112 pediatric patients with end-stage renal disease from 1990 to 1995.It showed that children with severe or moderate growth failure had higher hospitalization rates compared to those with normal growth.Specifically,the relative risk for hospitalization was 1.14(95%CI:1.1-1.2)for those with moderate growth failure and 1.24(95%CI:1.2-1.3)for those with severe growth failure,even after adjusting for age,sex,race,cause,and duration of end-stage renal disease,and treatment type[2](dialysis or transplant).The growth of a child significantly affects his/her psychological and overall well-being as an adult.Short children are often embarrassed by peers,and it has been observed that height influences employment status,with unemployment being more prevalent among stunted individuals.Further,marital opportunities can be fewer among stunted individuals[3].Hence,all measures to achieve adequate growth should be attempted in children with CKD,regardless of whether they undergo transplantation.

Effects of recombinant human growth hormone (r-hGH) on experimental osteoporotic fracture healing

Objective:: To observe the effect of recombinant human growth hormone (r-hGH) on osteoporotic fracture healing in rats, and to provide an effective therapy for osteoporotic fracture. Methods: Thirty-six female 8-month-old SD rats were randomized into two groups: therapy group and control group. After the experimental model of osteoporotic fracture was established, the therapy group was treated with r-hGH of 2.7 mg/kg body weigh/day (1 mg=3 IU) for 10 days continuously by daily subcutaneous injection; whereas the control group was treated with equivalent saline. Plasma insulin-like growth factor I concentration was detected and bone mineral density (BMD) as well as biomechanical strength of callus were measured at 2, 4, 8 weeks. Results: Plasma insulin-like growth factor I concentration in the therapy group was higher than that in the control group (P< 0.005 ) at 2nd week and began to decline at 4th week. At 8th week, there was no significant difference between the two groups. At 4th week, callus area and BMD in therapy group were higher than those in the control group, but at 8th week, they were lower and BMD had a significant difference between the two groups (P< 0.001 ). Biomechanical testing of callus showed that torsional strength of the therapy group was higher than that of the control group at 4th or 8th week, meanwhile maximum torsional angle had a significant difference between the two groups (P< 0.005 ).Conclusions: The results show that exogenous r-hGH can stimulate osteoporotic fracture healing in rats.

重组人生长激素临床应用的安全性思考

重组人生长激素(recombinant human growth hormone,rhGH)是改善身材矮小的有效治疗药物,目前rhGH可应用于包含生长激素缺乏症在内的多种原因导致的身材矮小,临床应用的扩展使其安全性问题备受关注。基于现有证据,当rhGH规范应用于生理性替代治疗时,其安全性较好。临床中,应用rhGH进行治疗期间可结合文献证据和临床经验重点关注短期安全性,长期安全性由于rhGH治疗时间不足尚无准确定论。该文梳理了在rhGH治疗过程中有可能出现的不良事件及其风险控制措施,旨在帮助临床医生了解rhGH治疗的整体安全性,改善临床规范化应用。

枇杷叶三萜酸联合重组人表皮生长因子对激素依赖性皮炎豚鼠皮肤屏障功能的修复及免疫失衡的影响

目的 观察枇杷叶三萜酸(TAL)联合重组人表皮生长因子(rh-EGF)对激素依赖性皮炎(HDD)豚鼠模型皮肤屏障功能修复及免疫失衡的影响。方法 选取40只无特定病原(SPF)级豚鼠,随机分为对照组、模型组、rh-EGF组、TAL组和联合组,每组各8只。除对照组外,其他各组涂抹0.05%卤米松乳膏,连续45 d,构建HDD模型。构建成功后,rh-EGF组涂抹rh-EGF凝胶,TAL组涂抹TAL溶液,联合组涂抹TAL和rh-EGF凝胶,对照组和模型组涂抹生理盐水,共15 d。记录各组临床症状并打分;检测经皮水分丢失(TEWL)、角质层含水量(WCSC)和皮脂量(SC);HE染色观察各组豚鼠皮肤组织病理变化;采用酶联免疫吸附测定(ELISA)法检测总免疫球蛋白E(IgE)、白细胞介素-4(IL-4)、干扰素-γ(IFN-γ)水平。结果 与对照组比较,模型组症状明显、皮肤组织损坏严重,TEWL增加,WCSC和SC减少;免疫因子Ig E和IL-4水平升高、IFN-γ水平降低(P<0.05)。与模型组比较,rh-EGF组、TAL组和联合组用药后临床症状减轻、皮肤组织损伤不明显;TEWL减少,WCSC和SC增加,免疫因子IgE和IL-4水平降低、IFN-γ水平升高(P<0.05)。且联合组与rh-EGF组和TAL组比较,作用效果更加明显(P<0.05)。TAL组和联合组各指标比较,差异无统计学意义(P>0.05)。结论 TAL联合rh-EGF可有效缓解HDD豚鼠的临床症状,改善皮肤细胞损伤,修复皮肤屏障功能,提升免疫能力。

青春期矮身材儿童身高改善的药物治疗

青春期矮身材可严重影响青少年的身心健康。青春期由于性激素导致的骨龄持续加速进展,限制了生长所需的时间,是矮身材治疗的巨大挑战,至今仍无标准化的治疗方案。青春期也是改善成年终身高的最后机会。目前临床常用治疗药物主要有重组人生长激素、促性腺激素释放激素类似物和第三代芳香化酶抑制剂。近年来,以改善成年终身高为目的的个体化治疗成为临床关注的重点。该文对青春期矮身材儿童身高改善的药物治疗相关研究进行梳理总结,为临床医生提供参考.

特纳综合征临床诊疗管理的现状思考

特纳综合征(Turner syndrome,TS)的临床诊断存在延迟,尤其对于嵌合核型患者,诊断延迟将阻碍与年龄相适应的相关治疗,导致不良的健康结局。因此,有必要基于临床现状探索早期诊断和治疗方案的改善措施。此外,随着研究深入,TS的临床诊治重点逐渐扩展至心血管、生育力、过渡期等多方面,以提高患者的预后和生存质量。该文探讨了TS诊疗的临床现状和管理要点,旨在为改善TS诊疗管理提供思考。

不同剂量重组人生长激素治疗特发性矮小症患者的疗效观察

目的观察不同剂量重组人生长激素在特发性矮小症(ISS)患儿治疗中的影响。方法纳入河南科技大学第一附属医院2021年2月至2023月7月收治的61例ISS患儿,所有患儿均接受重组人生长激素(rhGH)治疗。依照rhGH治疗剂量的不同分为3组,分别是低剂量组20例(0.26 mg/kg)、中剂量组20例(0.35 mg/kg)、高剂量组21例(0.41 mg/kg)。观察在不同组别患儿身高、年生长速率及相关血检指标水平。结果治疗前、治疗3个月3组患儿身高相比,差异无统计学意义(P>0.05);治疗6个月后高剂量组患儿身高高于低剂量和中剂量组,差异具有统计学意义(P<0.05)。治疗前3组年生长速率相比,差异无统计学意义(P>0.05);治疗3个月、6个月后高剂量组年生长速率高于低、中剂量组,差异具有统计学意义(P<0.05)。治疗前3组血糖水平对比,差异无统计学意义(P>0.05);治疗3个月高剂量组血糖高于低、中剂量组,差异具有统计学意义(P<0.05);治疗6个月高剂量组血糖高于中剂量组、低于低剂量组,差异具有统计学意义(P<0.05)。3组治疗前、治疗3个月、6个月后的血清游离三碘甲状腺原氨酸(FT_(3)),血清游离甲状腺素(FT_(4)),促甲状腺激素(TSH)水平相比,差异无统计学意义(P>0.05)。结论高剂量rhGH治疗ISS效果明显,治疗时提高患者空腹血糖水平,因而高剂量rhGH治疗期间需对患儿上述两类指标进行严密监测。

重组人生长激素治疗对身材矮小症患儿血清IGF-1、Ghrelin及LP水平的影响

目的探讨重组人生长激素(rhGH)治疗对身材矮小症患儿的疗效及其对血清胰岛素样生长因子-1(IGF-1)、饥饿激素(Ghrelin)及瘦素(LP)水平的影响。方法选择该院2021年1—12月收治的身材矮小症患儿79例为研究对象,按照随机数字表法将其分为对照组39例和观察组40例。对照组采用加强营养,并补充钙质、微量元素和各种维生素等常规治疗,观察组在常规治疗的基础上给予rhGH治疗,两组治疗时间均为12个月。比较两组患儿治疗前和治疗12个月后身高、生长速度、身高标准差积分(HtSDS)及血清IGF-1、Ghrelin、LP水平变化,比较两组不良反应发生情况。结果治疗前,两组患儿身高、生长速度、HtSDS及血清IGF-1、Ghrelin、LP水平比较,差异均无统计学意义(P>0.05);治疗12个月后,两组患儿身高、HtSDS及血清IGF-1、LP水平均高于治疗前,生长速度均快于治疗前,血清Ghrelin水平均低于治疗前,差异均有统计学意义(P<0.05);观察组患儿治疗12个月后身高、HtSDS及血清IGF-1、LP水平均高于对照组,生长速度快于对照组,血清Ghrelin水平低于对照组,差异均有统计学意义(P<0.05);对照组患儿治疗期间未出现任何不良反应,观察组治疗期间出现甲状腺功能减退1例,膝部疼痛2例,但两组患儿不良反应发生率比较,差异无统计学意义(P>0.05)。结论rhGH可有效改善身材矮小症患儿血清IGF-1、Ghrelin及LP水平,促进患儿生长,临床疗效满意,安全性高,值得临床应用。

PPOS方案促排卵过程中添加重组人生长激素注射液对卵巢低反应患者IVF结局的影响

目的探讨在卵泡期高孕激素状态下促排卵(PPOS)方案中联合使用重组人生长激素注射液对卵巢低反应患者体外受精-胚胎移植结局的影响。方法选取2020-2022年在江西省妇幼保健院辅助生殖中心进行助孕治疗的患者2137例,按照是否在PPOS过程中使用重组人生长激素注射液分为试验组(n=730)和对照组(n=1407)。对2组的临床特征及治疗结局进行回顾性PSM分析。结果试验组获卵数(3.87±2.93 vs3.21±2.44,P<0.001)、可移植胚胎数(1.47±1.18vs1.31±1.12,P=0.008)、HCG阳性率(64.0%vs52.7%,P=0.004)均显著高于对照组。结论PPOS方案中联合使用重组人生长激素注射液可增加卵巢低反应患者获卵数,显著改善卵母细胞和胚胎的数量及质量,改善临床结局。

戈舍瑞林联合rhGH对中枢性性早熟患儿生长速度、子宫与卵巢容积及骨代谢的影响

目的探讨戈舍瑞林联合重组人生长激素(rhGH)对中枢性性早熟患儿生长速度、子宫与卵巢容积及骨代谢的影响。方法选取遵化市人民医院于2020年5月至2022年4月收治的84例诊断为中枢性性早熟的女童作为研究对象,采用随机数字表法分为观察组(n=42)和对照组(n=42)。对照组采用皮下注射戈舍瑞林治疗,观察组在对照组基础上加用rhGH治疗。计算两组患儿治疗前后生长速度、测定骨龄及预测成年身高;B超下观察并计算两组患儿子宫和卵巢容积;采用电化学发光免疫分析法检测Ⅰ型原胶原氨基N端前肽(PINP)、Ⅰ型胶原羧基端肽交联(β-CTX)、骨钙素N端中分子片段(N-MID)水平;采用放射免疫法检测卵泡刺激素(FSH)、雌二醇(E_(2))和黄体生成素(LH)水平。结果治疗前两组患儿身高、预测成年身高、生长速度、骨龄、子宫和卵巢容积、PINP、β-CTX、N-MID、E_(2)、FSH和LH水平比较,差异无统计学意义(P>0.05)。治疗后两组患儿身高、预测成年身高及生长速度较治疗前增加,且观察组治疗后身高、预测成年身高、生长速度高于对照组(t=2.812、2.159、2.049,P<0.05);治疗后两组患儿子宫和卵巢容积较治疗前缩小,且观察组小于对照组(t=5.014、3.492,P<0.05);治疗后两组患儿PINP、N-MID、E_(2)、FSH和LH水平较治疗前下降,且观察组低于对照组(t=3.503、2.230、3.694、3.158、2.458,P<0.05)。观察组和对照组不良反应发生率比较,差异无统计学意义(P>0.05)。结论戈舍瑞林联合rhGH能够减缓中枢性性早熟患儿第二性征发育,调节骨代谢和性激素水平。