Robles-Valdés C, Altamirano N, Calzada-León R, Llanas-Hernández D, Parás-García G
Servicio de Endocrinología, Instituto Nacional de Pediatría, Secretaría de Salud, México, D.F.
Bol Med Hosp Infant Mex. 1993 Feb;50(2):102-9.
Ten growth hormone deficient patients (GHDP) (six girls & four boys) with chronological age range six-15 years old, received recombinant human growth hormone (GH) (0.6 UI/kg/week) in three subcutaneous injections per week over 14 months. A complete physical examination was performed monthly; thyroid hormones concentrations every two months, as well as, bone age every four months were determined. Growth velocity was higher in the first six months' treatment (12.73 +/- 1.65 cm/yr vs 10.6 +/- 1.67 cm/yr; previous growth velocity 3.76 +/- 2.4 cm/yr). The variables with better prognosis were: lower previous growth velocity, lower chronological age (< 12 ys), lower bone age (< 8 ys), higher BMI than ideal; and higher acid alkaline phosphate during treatment. Two of ours patients developed biochemical hypothyroidism during the treatment period, and they needed hormonal substitutive therapy. With GH treatment a harmonious growth is obtain with bone age progress according chronological age. The height of GHDP treated with GH do not approaches the height range of their parents, probably due the time of treatment. In the follow-up of all patients treated with GH is important to realize periodical laboratories screenings looking for another hypothalamic and/or hypophyseal deficiencies.
十名年龄在6至15岁的生长激素缺乏患者(GHDP)(六名女孩和四名男孩),接受重组人生长激素(GH)(0.6国际单位/千克/周),每周皮下注射三次,持续14个月。每月进行一次全面体格检查;每两个月测定甲状腺激素浓度,每四个月测定骨龄。治疗的前六个月生长速度较高(12.73±1.65厘米/年对10.6±1.67厘米/年;之前的生长速度为3.76±2.4厘米/年)。预后较好的变量为:之前生长速度较低、实足年龄较小(<12岁)、骨龄较小(<8岁)、体重指数高于理想值;以及治疗期间酸性磷酸酶较高。我们的两名患者在治疗期间出现生化性甲状腺功能减退,需要激素替代治疗。通过GH治疗可实现与骨龄随实足年龄进展相协调的生长。接受GH治疗的GHDP患者的身高未达到其父母的身高范围,可能是由于治疗时间的原因。在所有接受GH治疗的患者的随访中,定期进行实验室筛查以寻找其他下丘脑和/或垂体缺陷很重要。