rhGH替代治疗对生长激素缺乏症患儿线性生长及空腹血糖的影响

目的:观察国产重组人生长激素(rhGH)替代治疗对生长激素缺乏症(GHD)患儿的治疗效果及短期替代治疗对空腹血糖(FBG)的影响.方法:用国产rhGH治疗确诊为GHD的患儿25例,剂量为0.1～0.15 U/(kg·d),每晚睡前皮下注射,每周6～7次.分别于治疗前及治疗3、6个月后进行随诊,由专人用同一量具测量患儿身高(Ht),体质量(Wt),计算体质指数(BMI)、身高标准差积分(HtSDS),禁食8h以上取上午8时空腹静脉血检测FBG.结果:rhGH治疗3、6个月后患儿HtSDS由-2.30±0.44分别增加至-1.77±1.23、-1.74±0.58(P＜0.05或P＜ 0.01),生长速率较治疗前明显提高(P＜0.01),FBG较治疗前增高(P＜0.05),但FBG尚均在正常范围.治疗3、6个月后的FBG均与初始治疗年龄呈正相关(r分别为0.418、0.456,P＜0.05).结论:国产rhGH短期替代治疗可以提高GHD患儿身高,治疗对空腹血糖有影响,初始治疗年龄较大者更应在治疗期间动态监测血糖.

Effects and Influence of Recombinant Human Growth Hormone Replacement Therapy on Linear Growth and Fasting Blood Glucose in Children with Growth Hormone Deficiency

Objective:To explore the therapeutic effects of replacement therapy with domestic recombinant human growth hormone (rhGH) on the liner growth and the fasting blood-glucose (FBG) in children with growth hormone deficiency (GHD). Methods: Twenty-five GHD children were treated with rhGH by subcutaneous injection every night before going to bed,and the dose was 0.1-0.15 U/(kg·d). The values of body height (Ht),body weight (Wt),body mass index (BMI) and height standard deviation score (HtSDS) were measured by designated personnel using the same measuring tool before and after treat ment for 3 and 6 months. The level of fasting blood glucose was tested in children at 8 am after at least 8 hours no food or drink. Results:After 3 and 6 months of rhGH therapy, the HtSDS increased from -2.30±0.44 to -1.77±1.23(P < 0.05), -1.74±0.58 (P < 0.001) and the growth rate increased significantly (P < 0.001). The value of FBG increased after 3 to 6 months of treatment (P < 0.05), but it was still in a normal range. The level of FBG was correlated with age of initial treatment (r = 0.418 and 0.456,P < 0.05). Conclusion:The rhGH replacement therapy can improve the height of children with GHD and affect the fasting glucose in children with GHD. The level of fasting glucose should be dynamically monitored during the treatment,es pecially for children with older age of initial treatment