Bechtold Susanne, Ripperger Peter, Dalla Pozza Robert, Bonfig Walter, Häfner Renate, Michels Hartmut, Schwarz Hans Peter
University Children's Hospital, Division of Endocrinology and Diabetology, Munich, Germany.
J Clin Endocrinol Metab. 2007 Aug;92(8):3013-8. doi: 10.1210/jc.2007-0544. Epub 2007 May 29.
GH treatment stimulates growth in short children with juvenile idiopathic arthritis (JIA). The extent to which this therapy increases final height is not known.
Thirty-one growth-retarded children with systemic and polyarticular idiopathic arthritis were enrolled in this controlled study. After a mean observational time of 8.4 yr, final height was reached in 13 patients (seven females and six males) treated with GH for a mean of 6.7 yr in a dose of 0.33 mg/kg body weight per week. Eighteen patients (12 females and six males) served as an untreated control group.
Mean increment in height in the treatment group was 1.6 +/- 0.8 SD, whereas the patients of the control group lost 0.7 +/- 1.8 SD. Overall, mean final height in the treatment group was -1.6 SD and in the control group -3.4 SD. More GH-treated patients reached a final height within target height than untreated patients (11 of 13 vs. four of 18). Disease activity markers had a significant influence on height outcome. After adjustment for baseline and average disease activity, the difference between treatment and control group was still significant (mean 1.5 SD). Patients with a moderate overall disease activity profited most from GH treatment. No adverse events were noted throughout the study.
Our data suggest that long-term GH therapy has a beneficial effect on growth and final height in the majority of growth retarded children with severe forms of JIA.
生长激素（GH）治疗可促进幼年特发性关节炎（JIA）患儿的生长。但该疗法对最终身高增加的程度尚不清楚。
31名患有全身型和多关节型特发性关节炎且生长发育迟缓的儿童被纳入这项对照研究。平均观察8.4年后，13例接受GH治疗的患者（7名女性和6名男性）达到了最终身高，他们接受GH治疗的平均时间为6.7年，剂量为每周0.33mg/kg体重。18例患者（12名女性和6名男性）作为未治疗的对照组。
治疗组的平均身高增量为1.6±0.8标准差，而对照组患者身高下降了0.7±1.8标准差。总体而言，治疗组的平均最终身高为-1.6标准差，对照组为-3.4标准差。达到目标身高范围内最终身高的接受GH治疗的患者比未治疗患者更多（13例中的11例 vs. 18例中的4例）。疾病活动指标对身高结果有显著影响。在对基线和平均疾病活动进行校正后，治疗组与对照组之间的差异仍然显著（平均1.5标准差）。总体疾病活动程度为中度的患者从GH治疗中获益最大。在整个研究过程中未观察到不良事件。
我们的数据表明，长期GH治疗对大多数患有严重JIA的生长发育迟缓儿童的生长和最终身高有有益影响。
