Schaefer F, Wühl E, Haffner D, Mehls O
Department of Pediatrics, University of Heidelberg, Germany.
Adv Perit Dial. 1994;10:321-6.
Fourteen patients on hemodialysis (HD) and 17 patients on continuous peritoneal dialysis (CPD) were treated with 28-30 IU/m2/week of recombinant human growth hormone (rhGH) for at least 12 months. The HD and CPD patient groups were comparable with regard to age, bone age, height standard deviation scores (SDS), and height velocity at start of treatment. During the first year of rhGH treatment, height velocity increased from 2.9 +/- 1.9 to 5.5 +/- 1.7 cm/year in the HD group and from 3.0 +/- 2.2 to 7.2 +/- 3.2 cm/year in the CPD group. The increase in growth rate was significant in both groups (p < 0.001), and tended to be significantly greater in the CPD than in the HD group (p = 0.09). The marked acceleration of growth under rhGH treatment resulted in an increase in relative height by 0.37 +/- 0.38 SDS in the HD group and by 0.47 +/- 0.69 SDS in the CPD group during the first treatment year. Seven HD and 7 CPD patients completed a second year of rhGH treatment. In these patients, height velocity dropped to 3.6 +/- 2.7 cm/year (HD) and 3.6 +/- 2.3 cm/year (CPD), respectively during the second treatment year. We conclude that rhGH treatment accelerates growth in children both on HD and CPD. The treatment response tends to be greater in CPD compared to HD patients. The efficacy of treatment decreases considerably during the second treatment year.
14名接受血液透析(HD)的患者和17名接受持续腹膜透析(CPD)的患者接受了28 - 30 IU/m²/周的重组人生长激素(rhGH)治疗,治疗时间至少为12个月。HD组和CPD组患者在年龄、骨龄、身高标准差评分(SDS)以及治疗开始时的身高增长速度方面具有可比性。在rhGH治疗的第一年,HD组的身高增长速度从2.9±1.9厘米/年增加到5.5±1.7厘米/年,CPD组从3.0±2.2厘米/年增加到7.2±3.2厘米/年。两组的生长速度增加均具有显著性(p < 0.001),且CPD组的增加幅度有比HD组更大的趋势(p = 0.09)。rhGH治疗下生长的显著加速导致HD组在治疗的第一年相对身高增加了0.37±0.38 SDS,CPD组增加了0.47±0.69 SDS。7名HD患者和7名CPD患者完成了rhGH治疗的第二年。在这些患者中,治疗的第二年身高增长速度分别降至3.6±2.7厘米/年(HD)和3.6±2.3厘米/年(CPD)。我们得出结论,rhGH治疗可加速HD和CPD患儿的生长。与HD患者相比,CPD患者的治疗反应往往更大。在治疗的第二年,治疗效果显著下降。