Bundak R, Hindmarsh P C, Smith P J, Brook C G
Endocrine Unit, Middlesex Hospital, London, England.
J Pediatr. 1988 Jun;112(6):875-9. doi: 10.1016/s0022-3476(88)80207-5.
Seventy-eight children with idiopathic growth hormone deficiency treated with human growth hormone continuously for up to 5 years were studied; 58 were prepubertal at the start of treatment, and remained so throughout the treatment period, and 20 were showing pubertal signs at the start of treatment. Height velocity increased markedly in the prepubertal group over the first year of therapy, with a gradual decrease in the following years. The increased growth rate of the first treatment year continued in the pubertal group. Height standard deviation score for chronologic age increased significantly throughout all treatment years, but for bone age did not change in either group. The more frequent the treatment regimen, the better was the growth response; a dose effect independent of frequency was identified. Thus human growth hormone treatment cannot make up a deficit in height prognosis already present at diagnosis, but prevents further loss of stature, which is why early diagnosis is important.
对78例患有特发性生长激素缺乏症且持续接受人生长激素治疗长达5年的儿童进行了研究;58例在治疗开始时为青春期前儿童,并在整个治疗期间一直保持,20例在治疗开始时已出现青春期体征。青春期前组在治疗的第一年身高增长速度显著增加,在随后几年逐渐下降。青春期组在第一年治疗中增加的生长速度得以持续。按实际年龄计算的身高标准差评分在所有治疗年份均显著增加,但两组的骨龄均未改变。治疗方案越频繁,生长反应越好;确定了与频率无关的剂量效应。因此,人生长激素治疗不能弥补诊断时已存在的身高预后缺陷,但可防止身高进一步丢失,这就是早期诊断很重要的原因。