Zucchini S, Cacciari E, Balsamo A, Cicognani A, Tassinari D, Barbieri E, Gualandi S
Department of Pediatrics, University of Bologna, Bologna, Italy.
Arch Dis Child. 2001 Apr;84(4):340-3. doi: 10.1136/adc.84.4.340.
To compare final height in two groups of low birth weight children examined for short stature: the first group untreated because of normal growth hormone (GH) secretion, the second treated with human growth hormone (hGH) because of abnormal secretion.
A total of 49 subjects born at term of birth weight below the 10th centile were consecutively examined for idiopathic short stature. The first group of subjects (n = 20) with normal GH peaks after pharmacological tests (>8 microg/l) spontaneously reached final height. The second group (n = 29) with abnormal secretion were treated with hGH (20 U/m(2)/week) for 36-84 months. At diagnosis the two groups were of similar height for chronological age and bone age, and had similar target height.
In both groups final height was significantly lower than target height (-0.65 (SEM 0.20) in untreated cases, -0.61 (0.18) in treated cases). Fewer than one third of subjects had a final height above target height. Final height data of untreated and treated cases were not different. In the treated group the best results were obtained by those subjects who improved their height for bone age after three years of therapy.
Our subjects with birth weight below the 10th centile remained as short adults with final height below target height. Treatment with hGH 20 U/m(2)/week in those diagnosed as deficient was not effective, with final results overlapping those of untreated subjects.
比较两组因身材矮小接受检查的低出生体重儿童的最终身高:第一组因生长激素(GH)分泌正常未接受治疗,第二组因分泌异常接受人生长激素(hGH)治疗。
共有49名足月出生体重低于第10百分位数的受试者因特发性身材矮小接受连续检查。第一组受试者(n = 20)在药物测试后GH峰值正常(>8微克/升),自然达到最终身高。第二组(n = 29)分泌异常,接受hGH(20 U/m²/周)治疗36 - 84个月。诊断时,两组按年龄和骨龄计算的身高相似,且目标身高相似。
两组的最终身高均显著低于目标身高(未治疗组为-0.65(标准误0.20),治疗组为-0.61(0.18))。不到三分之一的受试者最终身高高于目标身高。未治疗组和治疗组的最终身高数据无差异。在治疗组中,治疗三年后骨龄身高有所改善的受试者取得了最佳效果。
我们出生体重低于第10百分位数的受试者成年后仍身材矮小,最终身高低于目标身高。对诊断为生长激素缺乏的患者每周每平方米20 U的hGH治疗无效,最终结果与未治疗的受试者重叠。