Maxwell H, Rees L
British Association for Paediatric Nephrology.
Arch Dis Child. 1996 Jan;74(1):40-3. doi: 10.1136/adc.74.1.40.
Poor growth is a particular problem for children with congenital renal disease. A one year trial of the use of recombinant human growth hormone (rhGH) in eight infants and young children with chronic renal failure is reported here. At entry bone age was less than 2 years, mean (range) chronological age 1.9 (1.3-2.7) years, and glomerular filtration rate (GFR) was 17 (9-42) ml/min/1.73 m2. Height standard deviation score (SDS) was -3.3 (-4.6 to -2.0) and height velocity SDS was -1.3 (-3.1 to 0.7). One child was withdrawn when he received a renal transplant after 9.5 months. Two children required dialysis, but remained in the trial. Treatment with rhGH resulted in an increase in height SDS to -2.2 (-4.2 to -0.9), p = 0.0002, and height velocity SDS to 1.1 (-0.7 to 2.6), p = 0.006. There was no change in GFR and no serious adverse events. There was no effect on plasma lipids, calcium, phosphate, intact parathyroid hormone, or glucose. Alkaline phosphatase rose significantly. Thus rhGH improved growth in eight infants with chronic renal failure, with four children entering the normal range.
生长发育迟缓是先天性肾病患儿的一个特殊问题。本文报道了对8例慢性肾衰竭婴幼儿使用重组人生长激素（rhGH）进行的为期一年的试验。入组时骨龄小于2岁，平均（范围）实足年龄为1.9（1.3 - 2.7）岁，肾小球滤过率（GFR）为17（9 - 42）ml/min/1.73 m²。身高标准差评分（SDS）为 - 3.3（- 4.6至 - 2.0），身高增长速度SDS为 - 1.3（- 3.1至0.7）。1名儿童在9.5个月后接受肾移植时退出试验。2名儿童需要透析，但仍留在试验中。rhGH治疗使身高SDS增至 - 2.2（- 4.2至 - 0.9），p = 0.0002，身高增长速度SDS增至1.1（- 0.7至2.6），p = 0.006。GFR无变化，也无严重不良事件。对血浆脂质、钙、磷、完整甲状旁腺激素或血糖无影响。碱性磷酸酶显著升高。因此，rhGH改善了8例慢性肾衰竭婴幼儿的生长发育，4名儿童进入正常范围。
