The Perelman School of Medicine, University of Pennsylvania, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA.
The George Washington University School of Medicine, Children's National Hospital, Washington, DC 20010, USA.
J Clin Endocrinol Metab. 2022 Feb 17;107(3):847-861. doi: 10.1210/clinem/dgab746.
The use of recombinant human growth hormone (rhGH) in children and adolescents has expanded since its initial approval to treat patients with severe GH deficiency (GHD) in 1985. rhGH is now approved to treat several conditions associated with poor growth and short stature. Recent studies have raised concerns that treatment during childhood may affect morbidity and mortality in adulthood, with specific controversies over cancer risk and cerebrovascular events. We will review 3 common referrals to a pediatric endocrinology clinic, followed by a summary of short- and long-term effects of rhGH beyond height outcomes. Methods to mitigate risk will be reviewed. Finally, this information will be applied to each clinical case, highlighting differences in counseling and clinical outcomes. rhGH therapy has been used for more than 3 decades. Data are largely reassuring, yet we still have much to learn about pharmaceutical approaches to growth in children and the lifelong effect of treatment.
自 1985 年重组人生长激素（rhGH）最初被批准用于治疗严重生长激素缺乏症（GHD）患者以来，其在儿童和青少年中的应用已经扩大。rhGH 现在被批准用于治疗几种与生长不良和身材矮小相关的疾病。最近的研究引起了人们的关注，即儿童时期的治疗可能会影响成年后的发病率和死亡率，特别是在癌症风险和脑血管事件方面存在争议。我们将回顾儿科内分泌诊所的 3 种常见转介情况，然后总结 rhGH 除了身高结果之外对短期和长期的影响。将审查降低风险的方法。最后，将这些信息应用于每个临床病例，突出咨询和临床结果的差异。rhGH 治疗已经使用了 30 多年。数据基本上是令人安心的，但我们仍然需要了解很多关于儿童生长的药物治疗方法以及治疗的终身影响。
