Bartosh S, Kaiser B, Rezvani I, Polinsky M, Schulman S, Palmer J, Baluarte H J
Division of Pediatric Nephrology, St. Christopher's Hospital for Children, Philadelphia.
Pediatr Nephrol. 1992 Jan;6(1):68-73. doi: 10.1007/BF00856841.
The efficacy of recombinant human growth hormone (rGH) was assessed in five pediatric allograft recipients with severe growth retardation despite successful renal transplants. rGH 0.05 mg/kg per dose was given six times weekly by subcutaneous injection to five prepubertal children (mean age 15.2 +/- 2.0 years) all of whom had bone ages less than or equal to 12 years (10.0 +/- 1.4 years), a height standard deviation score of less than -2.5 (-4.9 +/- 1.5), no evidence of catch-up growth, a calculated glomerular filtration rate (GFR) of more than 40 ml/min per 1.73 m2 (51 +/- 6.8 ml/min per 1.73 m2), and stable renal function on alternate-day prednisone (16.7 +/- 2.6 mg/m2 per dose). Growth hormone profiles were abnormal in all children before treatment. rGH administration led to a significant increase in both growth rate (3.5 +/- 1.6 cm/year pre therapy, 8.5 +/- 1.4 cm/year post therapy, P less than 0.001) and percentage of expected growth velocity for bone age (67 +/- 31% pre therapy, 163 +/- 27% post therapy, P less than 0.001) with evidence of true catch-up growth. During the study period, three children had the appearance of secondary sexual characteristics, and one had premature advancement of his bone age. GFR decreased in three children, and in one rGH was discontinued due to a steady rise in serum creatinine. No significant changes were seen in serum calcium, phosphorus, cholesterol, triglycerides, glucose, or thyroid function, although a significant increase in alkaline phosphatase was found. In summary, growth-retarded pediatric renal allograft recipients may have abnormal endogenous GH production and respond favorably to rGH.(ABSTRACT TRUNCATED AT 250 WORDS)
在五名儿科同种异体移植受者中评估了重组人生长激素（rGH）的疗效，这些患儿尽管肾移植成功，但仍严重生长迟缓。对五名青春期前儿童（平均年龄15.2±2.0岁）皮下注射rGH，剂量为0.05mg/kg，每周六次，所有患儿骨龄均小于或等于12岁（10.0±1.4岁），身高标准差评分小于-2.5（-4.9±1.5），无追赶生长迹象，计算的肾小球滤过率（GFR）大于40ml/min/1.73m²（51±6.8ml/min/1.73m²），且在隔日服用泼尼松（剂量为16.7±2.6mg/m²）时肾功能稳定。治疗前所有儿童的生长激素水平均异常。给予rGH后，生长速率（治疗前3.5±1.6cm/年，治疗后8.5±1.4cm/年，P<0.001）和骨龄预期生长速度百分比（治疗前67±31%，治疗后163±27%，P<0.001）均显著增加，并有真正追赶生长的证据。在研究期间，三名儿童出现了第二性征，一名儿童骨龄提前。三名儿童的GFR下降，一名儿童因血清肌酐持续升高而停用rGH。血清钙、磷、胆固醇、甘油三酯、葡萄糖或甲状腺功能无显著变化，尽管碱性磷酸酶显著升高。总之，生长迟缓的儿科肾移植受者可能内源性生长激素分泌异常，对rGH反应良好。（摘要截短至250字）
