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青春期前生长激素整合浓度低于正常水平的男孩接受生长激素治疗后的最终身高

Final height after growth hormone therapy in peripubertal boys with a subnormal integrated concentration of growth hormone.

作者信息

Zadik Z, Mira U, Landau H

机构信息

Pediatric Endocrine Unit, Kaplan Hospital, Rehovot, Israel.

出版信息

Horm Res. 1992;37(4-5):150-5. doi: 10.1159/000182300.

DOI:10.1159/000182300
PMID:1490656
Abstract

The aim of this study was to test the effect of growth hormone (GH) therapy on final height in peripubertal boys with idiopathic short stature in whom a subnormal integrated concentration of GH (< 3.2 micrograms/l) was found. Twenty-eight peripubertal children were studied. Height was below 2 SD for age, growth velocity was < 4.5 cm/year, bone age was more than 2 SD below mean for age and GH response to provocative tests was more than 10 micrograms/l. Eleven subjects (group B) were treated with recombinant GH 0.75 unit/kg/week, divided into 3 weekly doses for 2 years, and then the same weekly dose divided into daily injections was administered until final height was attained. Seventeen untreated children (group A) who were followed until cessation of growth served as controls. The GH-treated patients reached their target heights (-2.1 +/- 0.5, mean +/- SD in SDS) and predicted heights (-1.8 +/- 0.8) determined by the Bayley and Pinneau method, while the final heights of the untreated patients were significantly lower than their target heights and their predicted final heights (-2.7 +/- 0.7, -1.8 +/- 1.0 and -2.7 +/- 0.7, respectively). The main effect of GH was observed during the 1st year of treatment when height velocity was significantly higher in the GH-treated group than in the untreated one (9.3 +/- 2.1 vs. 5.3 +/- 1.1, respectively, p < 0.001). The high cost of the treatment in this specific age group should be weighed against the results.

摘要

本研究的目的是测试生长激素(GH)治疗对青春期前特发性身材矮小男孩最终身高的影响,这些男孩的GH整合浓度低于正常水平(<3.2微克/升)。对28名青春期前儿童进行了研究。身高低于年龄标准差2,生长速度<4.5厘米/年,骨龄比年龄均值低2个标准差以上,且对激发试验的GH反应>10微克/升。11名受试者(B组)接受重组GH治疗,剂量为0.75单位/千克/周,分3次每周给药,持续2年,然后将相同的每周剂量改为每日注射,直至达到最终身高。17名未接受治疗的儿童(A组)作为对照,随访至生长停止。接受GH治疗的患者达到了目标身高(SDS中为-2.1±0.5,均值±标准差)和根据贝利和皮诺方法确定的预测身高(-1.8±0.8),而未接受治疗的患者的最终身高显著低于其目标身高和预测的最终身高(分别为-2.7±0.7、-1.8±1.0和-2.7±0.7)。在治疗的第1年观察到GH的主要作用,此时接受GH治疗组的身高增长速度显著高于未治疗组(分别为9.3±2.1与5.3±1.1,p<0.001)。在这个特定年龄组中,应权衡治疗的高成本与治疗结果。

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引用本文的文献

1
In children with idiopathic short stature, what advantage does administering recombinant growth hormone have over observation in final adult height?: Part A: Evidence-based answer and summary.对于特发性身材矮小的儿童,与观察相比,给予重组生长激素对最终成年身高有何优势?:A部分:循证答案与总结。
Paediatr Child Health. 2003 Nov;8(9):569-70. doi: 10.1093/pch/8.9.569.
2
High dose growth hormone treatment induces acceleration of skeletal maturation and an earlier onset of puberty in children with idiopathic short stature.高剂量生长激素治疗可促使特发性身材矮小儿童的骨骼成熟加速,并使青春期提前开始。
Arch Dis Child. 2002 Sep;87(3):215-20. doi: 10.1136/adc.87.3.215.