Skinner A M, Clayton P E, Addison G M, Price D A
Department of Child Health, University of Manchester, Royal Manchester Children's Hospital, UK.
Horm Res. 1995;44(4):147-51. doi: 10.1159/000184615.
Non-compliance has been reported as a major issue in growth hormone (GH) therapy. We explored the use of urinary GH (uGH) measurements to monitor the GH treatment of 18 children (aged 5-16 years) diagnosed as GH deficient on the basis of history, phenotype, auxology and peak GH concentration during 2 provocation tests of < 15 mU/l. Each child collected 5 consecutive overnight urine samples while on GH replacement schedules, then discontinued treatment for 2 days and collected a further 5 urine samples. The mean mass of uGH excreted on treatment (8.6 ng, range 3.6-13.0 ng) was significantly greater than that off treatment (1.2 ng, range 0.6-2.7 np; p < 0.01). All uGH values on treatment exceeded the mean nocturnal uGH excretion of normal age- and sex-matched children. The clear distinction between uGH levels on and off GH treatment indicates that uGH measurement would determine whether two or more GH injections had been missed. A series of uGH estimates over a 2-week period may provide a realistic perspective on injection frequency.
据报道，不依从是生长激素（GH）治疗中的一个主要问题。我们探讨了使用尿生长激素（uGH）测量来监测18名儿童（年龄5 - 16岁）的GH治疗情况，这些儿童根据病史、表型、体格学以及两次激发试验中生长激素峰值浓度<15 mU/l被诊断为生长激素缺乏。每个儿童在接受GH替代治疗期间连续收集5份夜间尿液样本，然后停止治疗2天并再收集5份尿液样本。治疗期间排泄的uGH平均质量（8.6 ng，范围3.6 - 13.0 ng）显著高于停止治疗期间（1.2 ng，范围0.6 - 2.7 ng；p < 0.01）。治疗期间所有uGH值均超过年龄和性别匹配的正常儿童夜间uGH排泄平均值。GH治疗期间和停止治疗期间uGH水平的明显差异表明，uGH测量可以确定是否漏打了两针或更多针。在2周内进行一系列uGH估计可能会提供关于注射频率的实际情况。
