重组人生长激素对生长激素缺乏症患儿部分相关激素水平的影响

摘要

Objective:To investigate the effect of recombinant human growth hormone (rhGH) treatment to children with growth hormone deficiency (GHD) and the influence on related hormone levels.Methods:Sixty-four GHD children were recruited and were given rhGH injection once a day (0.1 ～0.15 IU/kg) for 6 months.Their body hight (Ht),hight standard deviation integrat (Ht-SDS),growth velocity (GV),body mass index (BMI),bone age/actual age (BA/CA) were observed before and 6 months and 12 months after the treatment.The increases of Ht,and Ht-SDS,and other GV indexes at the 3rd,6th,9th and 12th months after the treatment were compared.The thyroid hormone,insulin-like growth factor 1 (IGF-1),insulin-like growth factor binding protein 3 (IGFBP-3) were observed before and 6 months and 12 months after the treatment.The untoward effects of these childred were followed up and recorded.Results:The Ht,Ht-SDS,and GV levels of children were significantly improved in 6 months and 12 months after treatment than before(P ＜0.05),but BMI and BA/CA after treatment were not significantly different from those before (P ＞ 0.05).The increasing speeds of Ht,Ht-SDS,and GV decreased along with the prolongation of the treatment.The levels of serum IGF1,IGFBP-3,and FT3 were significantly increased in 6 months and 12 months after the treatment,and the levels of IGF-1 and IGFBP-3 in 12 months after treatment were significantly higher than those in 6 months(P ＜0.05).Conclusions:The rhGH treatment has obvious effect to GHD children in promoting growth,and it has not obvious influence on bone age maturation and weight.But it might have an impact on thyroid hormone metabolism.%目的:探讨重组人生长激素(rhGH)治疗儿童生长激素缺乏症(GHD)的疗效及对部分相关激素水平的影响.方法:64例GHD患儿作为研究对象给予rhGH 1次/d注射治疗,观察治疗前、治疗6个月及12个月时的身高(Ht)、身高标准差积分(Ht-SDS)、生长速率(GV)、体质指数(BMI)、骨龄/实际年龄比值(BA/CA),治疗3个月、6个月、9个月及12个月时身高增值(ΔHt)、身高标准差积分增值(ΔHt-SDS)及GV等生长指标变化,同时检测治疗前、治疗6个月及12个月时患儿的血清游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、血清胰岛素样生长因子-1(IGF-1)、血清胰岛素样生长因子结合蛋白-3(IGFBP-3)水平,随访12月并记录患儿的不良反应.结果:与治疗前比较,GHD患儿治疗6个月、12个月时的Ht、Ht-SDS及GV明显升高(P＜0.05),但BMI、BA/CA比值与治疗前比较差异无统计学意义(P＞0.05),且ΔHt、ΔHt-SDS及GV随着治疗时间的延长均呈下降趋势;治疗6个月、12个月时患儿血清的IGF-1、IGFBP-3及FT3水平均显著高于治疗前,治疗12个月时患儿血清的IGF-1、IGFBP-3水平显著高于治疗6个月时的水平(P＜0.05),治疗期间患儿无不良反应.结论:rhGH治疗儿童GHD具有明显的促生长效果,且不会对骨龄成熟、体重产生明显影响,但会对甲状腺激素代谢产生一定影响.