生长激素联合营养治疗对特发性矮小症患儿身体机能指标的影响

Effects of growth hormone combined with nutritional therapy on physical function indexes in children with idiopathic short stature

摘要

目的 探讨重组人生长激素(rhGH)联合营养治疗对特发性矮小症(ISS)患儿身体机能指标的影响。方法 选取2019年1月至2021年1月在西北妇女儿童医院治疗的102例5~12岁ISS患儿为研究对象,依据治疗方案将其分为对照组(n=46)与实验组(n=56);对照组采取饮食、行为指导常规治疗,实验组在其基础上加用rhGH皮下注射.比较两组患儿治疗前和治疗1年后体格相关指标(身高、体重、身高年增长速度及骨龄)、生长因子水平[胰岛素样生长因子-1(IGF-1)、胰岛素样生长因子结合蛋白-3(IGFBP-3)]及骨代谢相关指标[血清维生素D₃(25-OH-D₃)、骨碱性磷酸酶(BAP)及骨钙素(OC)]的差异;并比较两组患儿不良反应的发生情况。结果 治疗1年后,两组患儿身高、体重、身高年增长速度和骨龄均明显高于治疗前(t=-12.36~-4.01,P<0.05),且实验组患儿身高、体重、身高年增长速度较对照组均明显升高(t值分别为5.75、5.59、23.07,P<0.05),差异均有统计学意义.治疗1年后,两组患儿25-OH-D₃、BAP和OC水平均明显高于治疗前(t=-15.68~-3.49,P<0.05),且实验组患儿25-OH-D₃、BAP和OC水平较对照组均明显升高(t值分别为2.29、9.17、3.07,P<0.05),差异均有统计学意义.治疗1年后,两组患儿IGF-1和IGFBP-3水平均明显高于治疗前(t=-23.49~-4.12,P<0.05),且实验组患儿IGF-1和IGFBP-3水平较对照组均明显升高(t值分别为10.57和3.38,P<0.05),差异均有统计学意义.实验组不良反应发生率(16.07%)高于对照组(4.35%),但差异无统计学意义(χ²=3.61,P>0.05)。结论 rhGH联合营养治疗ISS患儿疗效显著,且安全性良好,值得临床推广.

Abstract

Objective To investigate the effect of recombinant growth hormone (rhGH) treatment with combined nutritional therapy on physical function indexes in children with idiopathic short stature (ISS). Methods A total of 102 children aged 5-12 years with ISS treated in Northwest Women's and Children's Hospital from January 2019 to January 2021 were selected as study subjects, and were divided into a control group (n=46) and an experimental group (n=56) according to the treatment plan. The control group received routine treatment with dietary and behavioral guidance. The experimental group was additionally injected with rhGH subcutaneously. The physical related indexes (height, weight, growth velocity and bone age), growth factors levels [insulin-like growth factor-1 (IGF-1), insulin-like growth factor-binding protein-3 (IGFBP-3)] and bone metabolism related indexes [serum 25-hydroxy-vitamin D₃ (25-OH-D₃), bone-specific alkaline phosphatase (BAP) and osteocalcin (OC)] were compared before and after one year's treatment between the two groups. The incidences of adverse reactions were also compared between the two groups. Results After 1 year of treatment, both groups of patients showed significant increases in height, weight, growth velocity, and bone age compared to before treatment (t=-12.36--4.01, P<0.05). The experimental group exhibited significantly higher increases in these parameters compared to the control group (t=5.75, 5.59 and 23.07, P<0.05), and the differences were statistically significant. The levels of 25-OH-D₃, BAP, and OC in both groups were significantly higher than those before treatment (t=-15.68--3.49, P<0.05), with the experimental group showing significantly higher levels compared to the control group (t=2.29, 9.17 and 3.07, P<0.05), and the differences were statistically significant. The levels of IGF-1 and IGFBP-3 in both groups were significantly higher than before treatment (t=-23.49--4.12, P<0.05), with the experimental group exhibiting significantly higher levels compared to the control group (t=10.57 and 3.38, P<0.05), and the differences were statistically significant. The incidence of adverse reactions in the experimental group (16.07%) was higher than the control group (4.35%), but the difference was not statistically significant (χ²=3.61, P>0.05). Conclusion rhGH combined with nutrition therapy in ISS children is effective and safe, and is worthy of clinical promotion.

关键词

生长激素 / 特发性矮小症 / 骨代谢 / 生长因子

Key words

growth hormone / idiopathic short stature / bone metabolism / growth factors

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基金资助

国家自然科学基金资助项目(81301869)

陕西省青年科技新星计划资助项目(2016KJXX-G23)