Thorner M O, Reschke J, Chitwood J, Rogol A D, Furlanetto R, Rivier J, Vale W, Blizzard R M
N Engl J Med. 1985 Jan 3;312(1):4-9. doi: 10.1056/NEJM198501033120102.
Two growth hormone-deficient children were treated with growth hormone-releasing factor for six months. The pattern of administration--1 to 3 micrograms per kilogram of body weight, given subcutaneously over one minute every three hours by infusion pump--was chosen to simulate growth hormone secretion in normal children. During the first week of therapy, both children had evidence of the metabolic effects of increased growth hormone secretion--i.e., nitrogen retention, demonstrated by decreased nitrogen excretion (P less than 0.05), and increased urinary calcium excretion (P less than 0.01). Growth hormone secretion was increased after pulses of growth hormone-releasing factor during the entire six-month period, and growth was accelerated. One child grew at a rate of 7.1 cm per year, as compared with 4.6 cm per year before therapy; the other grew at a rate of 13.7 cm per year, as compared with 2.1 cm per year before therapy, and had increased serum levels of somatomedin C. Growth hormone--releasing factor can restore growth hormone secretion and its biologic effects, including an increase in nitrogen retention, an increase in serum somatomedin C, and acceleration of linear growth in children with growth hormone deficiency. It is premature to speculate how useful this agent will prove to be in the treatment of children with growth hormone deficiency.
两名生长激素缺乏的儿童接受了生长激素释放因子治疗,为期6个月。给药方式为每3小时通过输液泵在1分钟内皮下注射1至3微克/千克体重,旨在模拟正常儿童的生长激素分泌情况。在治疗的第一周,两名儿童均出现了生长激素分泌增加的代谢效应证据,即氮潴留,表现为氮排泄减少(P<0.05),以及尿钙排泄增加(P<0.01)。在整个6个月期间,生长激素释放因子脉冲给药后生长激素分泌增加,生长加速。一名儿童治疗前每年生长4.6厘米,治疗后每年生长7.1厘米;另一名儿童治疗前每年生长2.1厘米,治疗后每年生长13.7厘米,且血清生长调节素C水平升高。生长激素释放因子可恢复生长激素分泌及其生物学效应,包括增加氮潴留、提高血清生长调节素C水平以及加速生长激素缺乏儿童的线性生长。目前推测该药物在治疗生长激素缺乏儿童方面的有效性还为时过早。