Livesey J H, Cuneo R C, Donald R A, Harris R G, Ibberston H K, Costello J M, Holdaway I M, Gluckman P D, Fraser T R, Chapman G E
Department of Endocrinology, Princess Margaret Hospital, Christchurch.
N Z Med J. 1989 Aug 9;102(873):399-402.
Ninety-four growth hormone deficient New Zealand children were treated with thrice weekly intramuscular injections of human pituitary growth hormone (GH) from 1979 to 1985 and the results from 43 children were analysed in detail. Their height velocity was mean (SD) 4.0 (1.9) cm/yr immediately prior to treatment and 8.5 (3.1) cm/yr in the first year of treatment. In each of the first three years of treatment the height velocity was significantly increased (p less than 0.001), but there was a significant decline in height velocity between the first and second, and second and third years. Nevertheless each year of treatment gave a highly significant gain in relative height. Bone age did not advance more rapidly than chronological age during the first two years of treatment, but did so subsequently. The response to GH, as assessed by the increase in relative height, was negatively correlated with the relative height at the start of treatment and with the maximum pretreatment plasma GH response to insulin hypoglycaemia. There was no correlation with pretreatment relative height velocity or aetiology of GH deficiency. Height velocity improved in five of 14 children treated with thyroxine after starting GH. Discontinuation of GH for one year in 34 children resulted in a highly significant reduction in growth rate from 7.5 (2.4) cm/yr to 2.5 (2.0) cm/yr, however four prepubertal children continued to grow at a rate exceeding 4 cm/yr.
1979年至1985年期间，94名生长激素缺乏的新西兰儿童接受了每周三次的人垂体生长激素（GH）肌肉注射治疗，并对其中43名儿童的治疗结果进行了详细分析。治疗前他们的身高增长速度平均（标准差）为4.0（1.9）厘米/年，治疗第一年为8.5（3.1）厘米/年。在治疗的前三年中，每年的身高增长速度均显著提高（p<0.001），但在第一年与第二年、第二年与第三年之间，身高增长速度出现了显著下降。尽管如此，每年的治疗都使相对身高有极显著的增加。在治疗的前两年中，骨龄的增长速度并不比实际年龄快，但随后出现了这种情况。通过相对身高的增加来评估，对GH的反应与治疗开始时的相对身高以及治疗前对胰岛素低血糖的最大血浆GH反应呈负相关。与治疗前的相对身高增长速度或GH缺乏的病因无关。开始使用GH后，14名接受甲状腺素治疗的儿童中有5名的身高增长速度有所改善。34名儿童停用GH一年后，生长速度从7.5（2.4）厘米/年显著降至2.5（2.0）厘米/年，然而，4名青春期前儿童的生长速度仍超过4厘米/年。
