重组人生长激素治疗不同垂体发育状况生长激素缺乏症患儿疗效的前瞻性研究

Therapeutic effect of recombinant human growth hormone on children with growth hormone deficiency and different pituitary developmental conditions: a prospective study

摘要:

目的 探讨重组人生长激素（recombinant human growth hormone，rhGH）对不同垂体发育状况生长激素缺乏症（growth hormone deficiency，GHD）患儿的治疗效果。方法 前瞻性选取2020年6月—2021年12月许昌市妇幼保健院收治的90例GHD患儿为研究对象，根据垂体正中矢状高径将患儿分为垂体发育不良组（45例）、垂体正常组（31例）、垂体发育增大组（14例）。分析比较各组身高、生长速率、身高标准差分值、血清胰岛素样生长因子结合蛋白-3、胰岛素样生长因子-1，以及治疗前后上述指标变化的差值（差值用△表示）。结果 治疗后3组身高、生长速率、身高标准差分值及血清胰岛素样生长因子结合蛋白-3、胰岛素样生长因子-1水平均高于治疗前（P<0.05）；垂体发育不良组、垂体发育增大组△身高、△生长速率、△身高标准差分值、△胰岛素样生长因子-1、△胰岛素样生长因子结合蛋白-3均大于垂体正常组（P<0.05）；3组不良反应发生率比较差异无统计学意义（P>0.05）。结论 rhGH治疗不同垂体发育的GHD患儿均有促进骨生长、增加身高的作用，对垂体发育不良及增生患儿效果更明显，且安全性可靠。

Abstract:

Objective To investigate the therapeutic effect of recombinant human growth hormone (rhGH) on children with growth hormone deficiency (GHD) and different pituitary developmental conditions.Methods A prospective study was performed on 90 children with GHD who were admitted to Xuchang Maternity and Child Health Hospital from June 2020 to December 2021. According to pituitary height on the median sagittal plane, they were divided into three groups: pituitary dysplasia group (n=45), normal pituitary group (n=31), and enlarged pituitary growth group (n=14). The changes in body height, growth velocity, height standard deviation score and serum levels of insulin-like growth factor binding protein-3 (IGFBP-3) and insulin-like growth factor-1 (IGF-1) were examined after treatment in the above three groups, and the differences of the above indices before and after treatment were compared among the three groups.Results After treatment, all three groups had significant increases in body height, growth velocity, height standard deviation score, and the serum levels of IGFBP-3 and IGF-1 (P<0.05). Compared with the normal pituitary group, the pituitary dysplasia group and the enlarged pituitary growth group had significantly higher values in terms of the differences in body height, growth velocity, height standard deviation score, IGF-1, and IGFBP-3 before and after treatment (P<0.05). There was no significant difference in the incidence rate of adverse reactions among the three groups (P>0.05).Conclusions In GHD children with different pituitary developmental conditions, rhGH can promote bone growth and increase body height, especially in children with pituitary dysplasia and pituitary hyperplasia, with good safety.