Bechtold S, Ripperger P, Häfner R, Said E, Schwarz H P
Endocrine Division, University Children's Hospital Munich, Lindwurmstrasse 4, D-80337 Munich, Germany.
J Pediatr. 2003 Oct;143(4):512-9. doi: 10.1067/S0022-3476(03)00390-1.
To evaluate the efficacy and safety of growth hormone treatment in severely growth retarded children with juvenile idiopathic arthritis (JIA) receiving glucocorticoids.
Children with systemic and polyarticular idiopathic arthritis (22 F, 16 M) with a mean age of 10.1 years were enrolled in this controlled study. Eighteen patients (9 F, 9M; mean age, 10.5 years) received growth hormone in a dose of 0.20 to 0.33 mg/kg body weight per week for 4 years. Twenty patients (13 F, 7 M; mean age, 9.6 years) served as an untreated control group.
Mean improvement in height in the treated group was 1 SD, whereas the patients of the control group lost 0.7 SD. Disease activity markers correlated significantly with the mean growth velocity standard deviation score. In general, children with mild or moderate disease and lower comedication grew and responded better to growth hormone therapy than those with active disease. No adverse events were noted.
Our data suggest that long-term growth hormone therapy has a beneficial effect in children with severe forms of JIA. Further data are needed to confirm the efficacy and safety of growth hormone and its effect on final height.
评估生长激素治疗对正在接受糖皮质激素治疗的重度生长迟缓幼年特发性关节炎(JIA)患儿的疗效及安全性。
本对照研究纳入了全身型和多关节型特发性关节炎患儿(22名女性,16名男性),平均年龄为10.1岁。18名患者(9名女性,9名男性;平均年龄10.5岁)接受生长激素治疗,剂量为每周0.20至0.33毫克/千克体重,持续4年。20名患者(13名女性,7名男性;平均年龄9.6岁)作为未治疗的对照组。
治疗组的身高平均改善了1个标准差,而对照组患者身高下降了0.7个标准差。疾病活动指标与平均生长速度标准差评分显著相关。总体而言,病情轻度或中度且联合用药较少的儿童,相比病情活跃的儿童,生长情况更好,对生长激素治疗的反应也更佳。未观察到不良事件。
我们的数据表明,长期生长激素治疗对重度JIA患儿有有益作用。需要更多数据来证实生长激素的疗效和安全性及其对最终身高的影响。