Kawaguchi H, Ito K
Department of Pediatric Nephrology, Tokyo Women's Medical College, Japan.
Br J Clin Pract Suppl. 1996 Aug;85:26-31.
We evaluated the effect of rhGH at both 0.5 and 1.0 i.u./kg/week, on the growth of 83 CRI (pre- and dialysis) and 23 transplanted children after one year. Growth velocity (GV) was significantly increased in predialysis children on a dose of 0.5 i.u. (p < 0.001), from 3.8cm/year at baseline to 7.8cm/year at six months and 7.3cm/year at one year. On a dose of 1.0 i.u., GV was increased from 4.5cm/year at baseline to 10.3cm/year at six months and 8.7cm/year at one year (p < 0.01). When the increment in GV was compared a significant difference was noted between 0.5 i.u. and 0.1 i.u. at both six and 12 months (p < 0.01). GV was also significantly increased in dialysed children treated with 0.5 i.u., from 3.5cm/year to 5.6cm/year at six months (p < 0.01) and 5.4cm/year at one year (p < 0.01). On a dose of 1.0 i.u., the increase was from 3.4 to 8.4cm/year at six months (p < 0.001) and 8.3cm/year at one year (p < 0.01). There was a significant difference in GV between the 0.5 and 1.0 i.u. groups at both six and 12 months (p < 0.01). In transplanted children, GV was significantly improved over one year of GH treatment from 5.0 to 7.7cm/year at 0.5 i.u. (p < 0.05) and from 3.7 to 6.3cm/year at 1.0 i.u. (p < 0.05); however, there was no statistical difference between the groups. Seven out of 23 children showed evidence of deterioration of graft function during rhGH treatment. This was due to acute rejection (AR) in every case. AR was noted in two of 10 children (20%) in the 0.5 i.u. group and five of 13 children (38%) in the 1.0 i.u. group. Our results demonstrate that rhGH effectively stimulates GV, not only in CRI, but also in dialysed children. Attention should, however, be paid to deterioration of renal function.
我们评估了每周0.5国际单位/千克和1.0国际单位/千克的重组人生长激素(rhGH)对83名慢性肾功能不全(CRI,透析前和透析中)儿童以及23名接受移植儿童一年生长情况的影响。接受0.5国际单位剂量rhGH治疗的透析前儿童生长速度(GV)显著增加(p<0.001),从基线时的3.8厘米/年增加到6个月时的7.8厘米/年和1年时的7.3厘米/年。接受1.0国际单位剂量rhGH治疗时,GV从基线时的4.5厘米/年增加到6个月时的10.3厘米/年和1年时的8.7厘米/年(p<0.01)。比较GV的增加量时,发现6个月和12个月时0.5国际单位和1.0国际单位之间存在显著差异(p<0.01)。接受0.5国际单位rhGH治疗的透析儿童GV也显著增加,从3.5厘米/年增加到6个月时的5.6厘米/年(p<0.01)和1年时的5.4厘米/年(p<0.01)。接受1.0国际单位剂量rhGH治疗时,增加量从6个月时的3.4厘米/年增加到8.4厘米/年(p<0.001)和1年时的8.3厘米/年(p<0.01)。6个月和12个月时,0.5国际单位组和1.0国际单位组的GV存在显著差异(p<0.01)。在接受移植的儿童中,接受0.5国际单位rhGH治疗一年后GV显著改善,从5.0厘米/年提高到7.7厘米/年(p<0.05),接受1.0国际单位rhGH治疗时从3.7厘米/年提高到6.3厘米/年(p<0.05);然而,两组之间无统计学差异。23名儿童中有7名在rhGH治疗期间出现移植肾功能恶化的迹象。这在每种情况下均是由于急性排斥反应(AR)所致。0.5国际单位组的10名儿童中有2名(20%)出现AR,1.0国际单位组的13名儿童中有5名(38%)出现AR。我们的结果表明,rhGH不仅能有效刺激CRI儿童的GV,也能刺激透析儿童的GV。然而,应注意肾功能的恶化。