Czernichow P, Fjellestad-Paulsen A
Department of Pediatric Endocrinology, Hôpital Robert-Debré, Paris, France.
Horm Res. 1998;49 Suppl 2:23-7. doi: 10.1159/000053083.
Growth acceleration and bone maturation were studied in children with severe short stature and a history of intrauterine growth retardation (IUGR) to determine the effect of growth hormone (GH)-treatment. Patients were enrolled in an open randomized, multicenter trial and allocated to either the treated group (group 1, n = 38) or the control group (group 2, n = 31). Both groups were treated daily with 0.2 IU/kg/body weight during 3 years. The children in group 2 started the study with a 1-year observation period followed by a 3-year treatment period. At baseline, the mean age was 4.5 years, bone age was 3.3 years, height standard deviation score (SDS) was -3.4, height velocity (HV) SDS was -1.6. Auxologic data were measured every 3 months and bone age was assessed at the start of the study (baseline) and then every 12 months thereafter. After 1 year of treatment, linear HV in group 1 increased significantly in comparison with the pretreatment period (from 5.7 +/- 2.0 to 10.1 +/- 1.7 cm/year; p < 0.001). Increased HV was sustained during the 2nd and 3rd year of treatment and was significantly higher than at baseline. A similar growth pattern was seen during the 3 years of growth hormone (GH) treatment in group 2. The mean height SDS for chronological age increased by 2.0 +/- 0.7 in the 2 groups after 3 years of treatment. Bone age remained retarded but increased with a mean of almost 4 years after 3 years of treatment in both groups. Even at a dose that is three times the replacement dose, treatment with recombinant human GH was well tolerated. From these results, we conclude that recombinant human GH treatment over 3 years can induce sustained catch-up growth in young children with severe short stature and a history of IUGR.
对严重身材矮小且有宫内生长迟缓（IUGR）病史的儿童进行生长加速和骨骼成熟情况研究，以确定生长激素（GH）治疗的效果。患者参加了一项开放随机、多中心试验，并被分配到治疗组（第1组，n = 38）或对照组（第2组，n = 31）。两组均在3年内每日接受0.2 IU/kg体重的治疗。第2组儿童先进行1年观察期，然后进入3年治疗期。基线时，平均年龄为4.5岁，骨龄为3.3岁，身高标准差评分（SDS）为 -3.4，身高生长速度（HV）SDS为 -1.6。每3个月测量一次人体测量学数据，并在研究开始时（基线）评估骨龄，此后每12个月评估一次。治疗1年后，第1组的线性HV与治疗前期相比显著增加（从5.7±2.0增至10.1±1.7 cm/年；p < 0.001）。治疗第2年和第3年HV持续增加，且显著高于基线水平。第2组在生长激素（GH）治疗的3年中也观察到类似的生长模式。治疗3年后，两组按实际年龄计算的平均身高SDS增加了2.0±0.7。骨龄仍滞后，但两组治疗3年后平均增加了近4岁。即使剂量是替代剂量的三倍，重组人生长激素治疗的耐受性也良好。从这些结果我们得出结论，对严重身材矮小且有IUGR病史的幼儿进行3年的重组人生长激素治疗可诱导持续的追赶生长。
