Leschek Ellen Werber, Rose Susan R, Yanovski Jack A, Troendle James F, Quigley Charmian A, Chipman John J, Crowe Brenda J, Ross Judith L, Cassorla Fernando G, Blum Werner F, Cutler Gordon B, Baron Jeffrey
Developmental Endocrinology Branch, National Institute of Child Health and Human Development/NIH, Building 10, Room 10N262, 10 Center Drive, MSC 1862, Bethesda, MD 20892-1862, USA.
J Clin Endocrinol Metab. 2004 Jul;89(7):3140-8. doi: 10.1210/jc.2003-031457.
GH is often used to treat children with idiopathic short stature despite the lack of definitive, long-term studies of efficacy. We performed a randomized, double-blind, placebo-controlled trial to determine the effect of GH on adult height in peripubertal children. Subjects (n = 68; 53 males and 15 females), 9-16 yr old, with marked, idiopathic short stature [height or predicted height < or = -2.5 sd score (SDS)] received either GH (0.074 mg/kg) or placebo sc three times per week until they were near adult height. At study termination, adult height measurements were available for 33 patients after mean treatment duration of 4.4 yr. Adult height was greater in the GH-treated group (-1.81 +/- 0.11 SDS, least squares mean +/- sem) than in the placebo-treated group (-2.32 +/- 0.17 SDS) by 0.51 SDS (3.7 cm; P < 0.02; 95% confidence interval, 0.10-0.92 SDS). A similar GH effect was demonstrated in terms of adult height SDS minus baseline height SDS and adult height SDS minus baseline predicted height SDS. Modified intent-to-treat analysis in 62 patients treated for at least 6 months indicated a similar GH effect on last observed height SDS (0.52 SDS; 3.8 cm; P < 0.001; 95% confidence interval, 0.22-0.82 SDS) and no important dropout bias. In conclusion, GH treatment increases adult height in peripubertal children with marked idiopathic short stature.
尽管缺乏关于生长激素(GH)疗效的确切长期研究,但它仍常被用于治疗特发性身材矮小的儿童。我们进行了一项随机、双盲、安慰剂对照试验,以确定GH对青春期前儿童成年身高的影响。研究对象(n = 68;53名男性和15名女性)年龄在9至16岁之间,患有明显的特发性身材矮小[身高或预测身高≤ -2.5标准差评分(SDS)],他们接受每周三次皮下注射GH(0.074 mg/kg)或安慰剂,直至接近成年身高。在研究结束时,平均治疗4.4年后,33名患者有成年身高测量数据。接受GH治疗组的成年身高(-1.81 ± 0.11 SDS,最小二乘均值 ± 标准误)比安慰剂治疗组(-2.32 ± 0.17 SDS)高0.51 SDS(3.7 cm;P < 0.02;95%置信区间,0.10 - 0.92 SDS)。在成年身高SDS减去基线身高SDS以及成年身高SDS减去基线预测身高SDS方面,也显示出类似的GH效果。对至少治疗6个月的62名患者进行的改良意向性分析表明,GH对最后观察到的身高SDS有类似效果(0.52 SDS;3.8 cm;P < 0.001;95%置信区间,0.22 - 0.82 SDS),且无重要的失访偏倚。总之,GH治疗可增加患有明显特发性身材矮小的青春期前儿童的成年身高。