高剂量重组人生长激素治疗特发性矮小疗效观察.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1，熊 丰1，朱 岷1，雷培芸2，邓蕾丽1 （400014 重庆，重庆医科大学附属儿童医院：内分泌科1，核医学科ecombinant 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(男性21例,女性39例)，每晚皮下注射rhGH 0.15～0.18 IU/kg·d，疗程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例患儿生长速率由治疗前的每年（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）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；长疗程的rhGH治疗未引起骨龄和青春期提前。 [关键词] 基因重组人生长激素； 特发性矮小症；长疗程 [中图法分类号] [文献标志码] A Efficiency of long-term recombinant human growth hormone therapy for children with idiopathic short stature Wang Xurong1, Xiong Feng1, Zhu Min1, Lei Peiyun2, Deng Leili2 (1Department of Endocrinology, 2Department of Nuclear Medicine, Childrens Hospital, Chongqing Medical University, Chongqing, 400014, China) [Abstract] Objective To assess the efficiency of recombinant human growth hormone (rhGH) for a long-term therapy for children with idiopathic short stature (ISS). Methods Sixty ISS children (21 males and females) were treated with rhGH 0.15 to 0.18 IU/kg daily by subcutaneous injection at periumbilical area or lateral thigh for 1 to 3 years. Changes of height, growth velocity, mean height standard deviation score (SDS), bone age and predicted adult height before and in every 6 month after therapy were measured. Side effects were evaluated. Results With different courses of treatment, the mean growth velocity was increased from (4.5±0.46) cm/year to (11.0 ±2.53 )cm/ year, (8.1 ±1.54) cm/year and (7.1 ±2.07) cm/year respectively for those children treated for 1, 2 and 3 years. Mean height SDS was increased form (-2.60±0.57) to (-1.62±0.64), (-1.29±0.89) and (-0.12±0.45) respectively. Predicted adult height was increased form (151.6±8.4