McCaughey E S, Mulligan J, Voss L D, Betts P R
University Child Health, Southampton University Hospitals, UK.
Lancet. 1998 Mar 28;351(9107):940-4. doi: 10.1016/S0140-6736(05)60604-6.
There are few data on the long-term outcome of growth-hormone treatment in short normal children. We assessed the impact of growth-hormone treatment on pubertal development and near-final height in girls.
In a randomised controlled trial, we studied ten girls, with a mean age of 8.07 years and height 2 SDs or more below the mean for their age, and eight short untreated controls matched for age, and 20 short untreated girls who did not give consent for randomisation. The girls received either 30 IU/m2 somatropin per week as daily subcutaneous injections or no treatment. We assessed pubertal staging and height gain every 6 months.
Eight treated girls completed a mean of 6.2 years' therapy. By a mean age of 16.4 years, their mean height SD score had changed significantly from -2.42 to -1.14 (p=0.008) and they were, on average, 7.5 cm taller than the girls in the control group (height SD scores did not change significantly from -2.55) and 6.0 cm taller than the non-consent group. The timing of each pubertal stage, and the age and amplitude of peak height velocity were similar for all groups.
Growth-hormone therapy effectively increased height SD score among short normal girls started on treatment in early to mid childhood, with no untoward effect on pubertal progression.
关于正常身材矮小儿童生长激素治疗的长期结果的数据较少。我们评估了生长激素治疗对女孩青春期发育和最终身高的影响。
在一项随机对照试验中,我们研究了10名女孩,她们的平均年龄为8.07岁,身高比同龄人平均身高低2个标准差或更多,以及8名年龄匹配的未接受治疗的身材矮小对照者,还有20名未同意随机分组的未接受治疗的身材矮小女孩。这些女孩每周接受30 IU/m²的生长激素皮下注射,每日一次,或者不接受治疗。我们每6个月评估一次青春期分期和身高增长情况。
8名接受治疗的女孩平均完成了6.2年的治疗。到平均年龄16.4岁时,她们的平均身高标准差评分从-2.42显著变化至-1.14(p=0.008),并且她们比对照组女孩平均高7.5厘米(对照组身高标准差评分从-2.55未发生显著变化),比未同意组高6.0厘米。所有组的每个青春期阶段的时间、身高增长峰值的年龄和幅度相似。
生长激素治疗有效地提高了在儿童早期至中期开始治疗的正常身材矮小女孩的身高标准差评分,对青春期进展没有不良影响。