Tönshoff B, Haffner D, Albers N, Offner G, Mehls O
Division of Pediatric Nephrology, University Children's Hospital, Heidelberg, Germany.
Br J Clin Pract Suppl. 1996 Aug;85:34-7.
The growth response to recombinant human growth hormone (rhGH) in post-renal transplantation children is variable. We sought to determine predictive factors of this variable effect of rhGH by analysis of a homogeneous group of 16 prepubertal children with a median age of 12.4 years (range 7.7-18.0 years). rhGH was given at 30 i.u./m2/week for at least one year. All children remained prepubertal during the study period. Height velocity increased from 2.5 +/- 0.4cm/year to 7.4 +/- 0.5cm/year after one year of treatment (p < 0.001). The growth response to rhGH (height velocity after one year of rhGH) was not significantly correlated with the dose of prednisolone administered (range 2.3-9.1mg/m2/day), graft function as estimated by creatinine clearances (range 19-88ml/min/1.73m2), the degree of stunting at baseline, baseline height velocity, or chronological age. However, a relatively tight inverse correlation was found between the growth response to rhGH and the degree of bone age delay (r = 0.73, p < 0.005). Hence, the degree of bone age delay appears to be a helpful clinical predictor of response to rhGH in short prepubertal children post-renal transplantation.
肾移植术后儿童对重组人生长激素(rhGH)的生长反应存在差异。我们试图通过分析一组年龄中位数为12.4岁(范围7.7 - 18.0岁)的16名青春期前儿童的同质群体,来确定rhGH这种可变效应的预测因素。rhGH以30国际单位/平方米/周的剂量给药,至少持续一年。在研究期间,所有儿童均处于青春期前。治疗一年后,身高增长速度从2.5±0.4厘米/年增加到7.4±0.5厘米/年(p < 0.001)。对rhGH的生长反应(rhGH治疗一年后的身高增长速度)与泼尼松龙给药剂量(范围2.3 - 9.1毫克/平方米/天)、通过肌酐清除率估算的移植肾功能(范围19 - 88毫升/分钟/1.73平方米)、基线时发育迟缓程度、基线身高增长速度或实际年龄均无显著相关性。然而,发现rhGH的生长反应与骨龄延迟程度之间存在相对紧密的负相关(r = 0.73,p < 0.005)。因此,骨龄延迟程度似乎是肾移植术后青春期前矮小儿童对rhGH反应的一个有用的临床预测指标。