Darendeliler F, Livesey E A, Hindmarsh P C, Brook C G
Endocrine Unit, Middlesex Hospital, London, U.K.
Acta Paediatr Scand. 1990 Oct;79(10):950-6. doi: 10.1111/j.1651-2227.1990.tb11357.x.
We have studied the growth of 144 children after treatment of brain tumours distant from the hypothalamo-pituitary axis. All had cranial irradiation and 87 spinal irradiation. In 56 patients observed without intervention for 3 years, height SDS in the cranial (CR) group (n = 20) declined from 0.02 to -0.44 and in the craniospinal (CS) group (n = 36) from -0.28 to -1.11. Failure of spinal growth had a marked effect in the CS group. The onset of puberty was slightly but not significantly advanced; median ages at onset of puberty were 10.3 years in girls and 12.1 years in boys. Of the total group 86.4% had clinical and biochemical evidence of growth hormone insufficiency. Fifty-two children, 33 (28 CS; 5 CR) of whom were prepubertal, received biosynthetic human growth hormone, in a dose of 15 mU/m2/week by daily injection for a period of one year. Height velocity SDS increased significantly in both groups from -2.74 to +1.90 (CS) and from -1.0 to +4.26 (CR). Spinal response to GH treatment was restricted in the craniospinal group.
我们研究了144例下丘脑 - 垂体轴以外脑肿瘤患儿治疗后的生长情况。所有患儿均接受了颅脑照射，87例接受了脊髓照射。56例患儿未进行干预观察3年，颅脑照射组（CR组，n = 20）身高标准差评分（SDS）从0.02降至 -0.44，全脑全脊髓照射组（CS组，n = 36）从 -0.28降至 -1.11。脊髓生长停滞在CS组有显著影响。青春期开始稍有提前但不显著；女孩青春期开始的中位年龄为10.3岁，男孩为12.1岁。在整个研究组中，86.4%有生长激素缺乏的临床和生化证据。52例患儿接受了生物合成人生长激素治疗，其中33例（28例CS组；5例CR组）为青春期前患儿，剂量为15 mU/m²/周，每日注射，为期一年。两组身高增长速度SDS均显著增加，CS组从 -2.74增至 +1.90，CR组从 -1.0增至 +4.26。全脑全脊髓照射组对生长激素治疗的脊髓反应受限。
