Ranke M B, Guilbaud O
University Children's Hospital, Tübingen, FRG.
Acta Paediatr Scand Suppl. 1990;370:122-30. doi: 10.1111/j.1651-2227.1990.tb11689.x.
In order that children with growth hormone deficiency (GHD) reach the goal of normal adult stature, treatment modalities need to be optimized. From the large database of patients enrolled in the Kabi International Growth Study (KIGS), 257 prepubertal patients with idiopathic GHD undergoing their first year of growth hormone (GH) substitution therapy were selected. A multiple regression analysis was performed to determine both auxiological factors characterizing the patients and the factors related to the chosen treatment modalities which are of significance for the observed magnitude of the growth response. Due to the structure of the data, pretreatment height velocity and bone age-derived auxiological data were not considered. It was observed that the magnitude of the growth response was inversely correlated with chronological age and relative height (HT SDS) at the start of GH treatment but was positively correlated with mid-parental height. The growth response was also positively correlated with the GH dose (IU/kg/week) and the frequency of GH injections per week. A regression equation using these five parameters was derived, allowing the growth response of these patients to be predicted. The extension of this analytical approach in the future will allow the treatment of patients with GHD to be tailored to individual requirements.
为了使生长激素缺乏症(GHD)患儿达到正常成人身高的目标,需要优化治疗方式。从卡比国际生长研究(KIGS)纳入的大量患者数据库中,选取了257例青春期前特发性GHD患儿,他们正在接受第一年的生长激素(GH)替代治疗。进行了多元回归分析,以确定表征患者的生长学因素以及与所选治疗方式相关的因素,这些因素对于观察到的生长反应幅度具有重要意义。由于数据结构的原因,未考虑治疗前身高增长速度和骨龄衍生的生长学数据。观察到生长反应幅度与GH治疗开始时的实足年龄和相对身高(身高标准差积分,HT SDS)呈负相关,但与父母平均身高呈正相关。生长反应也与GH剂量(国际单位/千克/周)和每周GH注射频率呈正相关。推导出了一个使用这五个参数的回归方程,从而可以预测这些患者的生长反应。未来这种分析方法的扩展将使GHD患者的治疗能够根据个体需求进行调整。