高剂量重组人生长激素治疗特发性矮小疗效观察 - 第三军医大学学报.doc

重组人生长激素治疗特发性矮小症1-3年疗效观察 王旭荣、熊 丰、朱 岷、雷培芸、邓蕾丽 重庆医科大学附属儿童医院内分泌科（400014） 摘要：目的 探讨基因重组人生长激素(Recombinant human growth hormone,rhGH)对特发性矮小症(Idiopathic short stature,ISS)儿童长疗程的疗效。方法 60例ISS患儿(男21例,女39例)，每晚皮下注射rhGH0.16～0.18IU/kg·d，治疗1～3年。评价治疗前后身高、生长速度、身高标准差计数(SDS)。rhGH治疗1-3年期间，60例患儿生长速率由每年(4.5±0.46)cm分别提高到(11.0±2.53)cm、(8.1±1.54)cm和(7.1±2.07)cm；身高SDS由治疗前(-2.60±0.57)增至(-1.62±0.64)、(-1.29±0.89)及(-0.12±0.45)；预测成人身高由治疗前(151.6±8.46)cm分别增加为(157.3±8.50)cm、(160.7±10.31)cm和(165.8±7.46)(P0.05)。 ⑵不同青春期开始治疗的疗效比较，TannerⅠ、Ⅱ、Ⅲ期患儿生长速率相接近，明显高于Ⅳ期。⑶骨龄增长低于身高年龄增长(P0.05)，而与年龄增长相一致（P0.05）结论 长疗程rhGH治疗对ISS有明显的促生长效应，增加了预测成年身高；青春期前、青春早中期开始治疗的疗效优于青春晚期；长疗程rhGH治疗未引起骨龄和青春期提前。以及过高的IGF-1水平。 关键词： 基因重组人生长激素； 特发性矮小；长疗程 Effect of therapy of Recombinant Human Growth Hormone in Children with Idiopathic Short Stature for one-three years WANG Xu-rong, XIONG Feng, ZHU Min, LEI Pei-yun, DENG Lei-li 　 Department of Endocrinology ,Childrens HospitalChongqing Medical University ,Chongqing 400014,China Abstract: Objective: To assess the effect of recombinant human growth hormone ( rhGH) for long course of treating children with idiopathic short stature (ISS). Methods: Sixty ISS children (21 males and females) were treated with rhGH 0.16～0.18IU/kg·d daily for 1-3 years. To measure the change of height,growth velocity,mean height standard deviation score (SDS),bone age and predicted adult height pre and every 6 month post therapy. Results: (1)With different courses of treatment,the mean growth velocity increased from (4.5±0.46)cm/year to 11.0 ±2.53cm/year、8.1 ±1.54cm/year and 7.1 ±2.07cm/year; mean height SDS increased form -2.60±0.57)to -1.62±0.64、-1.29±0.89 and -0.12±0.45; predicted adult height increased form 151.6±8.46cm to 157.3±8.50cm、160.7±10.31cm and 165.8±7.46cm (P0.05). (2) The growth velocity of ISS children in Tanner stage Ⅰ、Ⅱ、Ⅲwere similar and significantly better than the stage Ⅳ. (3) The acceleration of height age is faster than the bone age(P0.05)., whereas the acceleration of bone age is as fast as chro