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生长激素治疗既往有颅咽管瘤患儿的疗效与安全性:对1988年至1996年辉瑞国际生长数据库(KIGS)的分析

Efficacy and safety of growth hormone treatment in children with prior craniopharyngioma: an analysis of the Pharmacia and Upjohn International Growth Database (KIGS) from 1988 to 1996.

作者信息

Price D A, Wilton P, Jönsson P, Albertsson-Wikland K, Chatelain P, Cutfield W, Ranke M B

机构信息

Department of Child Health, University of Manchester, UK.

出版信息

Horm Res. 1998;49(2):91-7. doi: 10.1159/000023133.

DOI:10.1159/000023133
PMID:9485178
Abstract

We studied short- and long-term responses to growth hormone (GH) treatment and adverse medical events (AE) in 488 patients with craniopharyngioma who were entered into the Kabi International Growth Study (KIGS). First-year growth response and responsiveness (n = 394) were similar to those seen in children with idiopathic GH deficiency. The growth response over 5 years (n = 152) was unaffected by the recurrence of tumour and prior tumour management, but was greater in those receiving thyroxine. Mean height standard deviation scores (SDS) at the end of GH treatment (n = 129) was -0.7+/-1.2, and 79% achieved a height over -2 SD of target height, with evidence of further growth potential. Final height SDS correlated positively with height SDS at the start of treatment and with target height SDS, whereas gain in height SDS was inversely correlated with height SDS and bone age at the start of GH treatment. The rate of recurrence of tumour, 0.045/treatment year, was greater in those who had been treated with surgery alone compared to surgery and cranial irradiation. Other AE included headaches, fluid retention and convulsions occurring at rates of 0.025, 0.005 and 0.004/treatment year, respectively. We concluded that GH treatment is safe and effective in children with craniopharyngioma and provide data for counselling of parents about outcome during GH treatment.

摘要

我们对488例颅咽管瘤患者进行了生长激素(GH)治疗的短期和长期反应以及不良医学事件(AE)的研究,这些患者均纳入了卡比国际生长研究(KIGS)。第一年的生长反应和反应性(n = 394)与特发性生长激素缺乏症儿童相似。5年期间的生长反应(n = 152)不受肿瘤复发和既往肿瘤治疗的影响,但接受甲状腺素治疗的患者生长反应更大。生长激素治疗结束时(n = 129)的平均身高标准差评分(SDS)为-0.7±1.2,79%的患者身高达到目标身高标准差-2以上,并有进一步生长潜力的证据。最终身高SDS与治疗开始时的身高SDS以及目标身高SDS呈正相关,而身高SDS的增加与生长激素治疗开始时的身高SDS和骨龄呈负相关。单纯接受手术治疗的患者肿瘤复发率为0.045/治疗年,高于接受手术和颅脑照射的患者。其他不良事件包括头痛、液体潴留和惊厥,发生率分别为0.025、0.005和0.004/治疗年。我们得出结论,生长激素治疗对颅咽管瘤患儿是安全有效的,并为向家长咨询生长激素治疗期间的结果提供了数据。

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