首页|PEG-rhGH治疗特发性矮小症患儿对生长速率影响的临床研究

PEG-rhGH治疗特发性矮小症患儿对生长速率影响的临床研究

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目的 探讨特发性矮小症(ISS)患儿聚乙二醇重组人生长激素(PEG-rhGH)治疗后生长速率(GV),分析GV影响因素.方法 ISS患儿均先后接受PEG-rhGH治疗,每周0.16~0.17 mg·kg-1,皮下注射,注射部位为脐周、上臂外侧、大腿外侧,持续治疗1年,观察患儿治疗前后生长参数差异,记录治疗后患儿GV水平,通过多元逐步线性回归分析患儿治疗后1年GV水平影响因素.结果 ISS患儿治疗前及治疗1年后身高(Ht)分别为(109.51±12.59)和(123.16±13.07)cm,身高标准差积分(HtSDS)水平分别为-2.24±0.25和-1.71±0.21,GV 水平分别为(3.81±0.52)和(9.88±1.04)cm·year-1,25 羟维生素D水平分别为(27.19±3.14)和(33.05±3.46)ng·mL-1,Ⅰ型前胶原氨基端原肽(PINP)水平分别为(490.29±54.30)和(598.45±57.18)μg·L-1,胰岛素生长因子-Ⅰ(IGF-1)水平分别为(114.86±19.14)和(213.73±20.03)ng·mL-1,胰岛素样生长因子结合蛋白-3(IGFBP-3)水平分别为(6 817.27±716.30)和(7 230.39±721.45)ng·mL-1,治疗前上述指标与治疗组后比较,在统计学上差异均有统计学意义(均P<0.05).ISS患儿治疗前实际年龄(CA)为(8.05±1.09)岁,治疗前骨龄(BA)为(7.14±1.01)岁,治疗前骨龄差(BAD)为(-0.98±0.18)岁,治疗前骨龄指数(BAI)为0.86±0.12,遗传身高(MPH)为(167.31±5.73)cm.Pearson相关性分析显示ISS患儿治疗后GV水平与治疗前CA、治疗前BA、治疗前BAI呈负相关,与治疗前BAD、MPH呈正相关(均P<0.05);多元逐步线性回归分析结果显示治疗前高CA、BA、BAI水平为患儿PEG-rhGH治疗后低GV水平的危险因素,治疗前高BAD及MPH水平为保护因素.结论 ISS患儿PEG-rhGH治疗开始时年龄小、骨龄小者可获得较佳的GV应答,且遗传靶身高可影响患儿治疗后GV水平.
Clinical trial of PEG-rhGH in the treatment of children with idiopathic short stature
Objective To explore growth velocity(GV)and analyze its influencing factors in children with idiopathic short stature(ISS)after treatment with polyethylene glycol recombinant human growth hormone(PEG-rhGH).Methods The clinical data of children with ISS were retrospectively analyzed.All children were given subcutaneous injection of PEG-rhGH(0.16-0.17 mg·kg-1 each week)at periumbilical,lateral upper arm and thigh sites for 1 year.The differences in growth parameters before and after treatment were observed,and GV after treatment was recorded.The influencing factors of GV at 1 year after treatment were analyzed by multivariate stepwise linear regression analysis.Results Before and after 1 year of treatment,height(Ht)was(109.51±12.59)and(123.16±13.07)cm,height standard deviation scores(HtSDS)were-2.24±0.25 and-1.71±0.21,GV levels were(3.81±0.52)and(9.88±1.04)cm·year-1,levels of 25-hydroxy-vitamin-D[25(OH)D]were(27.19±3.14)and(33.05±3.46)ng·mL-1,levels of propeptide of type I procollagen(PINP)were(490.29±54.30)and(598.45±57.18)μg·L-1,levels of insulin-like growth factor-1(IGF-1)were(114.86±19.14)and(213.73±20.03)ng·mL-1,levels of insulin-like growth factor binding protein-3(IGFBP-3)were(6 817.27±716.30)and(7 230.39±721.45)ng·mL-1,the differences were statistically significant(all P<0.05).Before treatment,chronological age(CA),bone age(BA),bone age delay(BAD),bone age index(BAI)and mid-parental height(MPH)were(8.05±1.09)years,(7.14±1.01)years,(-0.98±0.18)years,0.86±0.12 and(167.31±5.73)cm,respectively.Pearson correlation analysis showed that GV level after treatment was negatively correlated with CA,BA and BAI before treatment,while positively correlated with BAD and MPH before treatment(P<0.05).The results of multivariate stepwise linear regression analysis showed that high levels of CA,BA and BAI before treatment were risk factors of low GV level after PEG-rhGH treatment,while high levels of BAD and MPH before treatment were protective factors.Conclusion GV response is good in ISS children with low age at the beginning of PEG-rhGH treatment and bone age.Genetic targeted height can affect GV after treatment.

polyethylene glycol recombinant human growth hormoneidiopathic short staturegrowth velocitybone age

王忻、邓茜、李敏、王娟娟

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安徽省儿童医院内分泌代谢科,安徽合肥 230011

聚乙二醇重组人生长激素 特发性矮小症 生长速率 骨龄

2024

中国临床药理学杂志
中国药学会

中国临床药理学杂志

CSTPCD北大核心
影响因子:1.91
ISSN:1001-6821
年,卷(期):2024.40(18)
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