Medical records of 174 GHD patients admitted to our hospital from June 2019 to January 2022 were retrospectively evaluated. A total of 136 patients met the inclusion criteria, of which 70 received 0.1 U/ (kg·d) (low-dose group) and 66 received 0.2 U/ (kg·d) dose of rhGH treatment (high-dose group). Growth and development status [height, weight, height standard deviation (HtSDS), growth rate], bone age, bone density, speed of sound (SOS) as distal radius bone mass, biochemical indicators of growth and development [insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein 3 (IGFBP-3)], growth hormone (GH) levels and incidence of adverse reactions were collected and compared between the two groups before and after one year of the treatment.
After the treatment, height, weight, HtSDS, and growth rate of the two groups increased compared to before the treatment and were significantly higher in the high-dose group than in the low-dose group (p<0.05). After one year of treatment, the following observations were made: the bone age of the two groups increased compared to the baseline values and was higher in the high-dose group compared to the low-dose group (p<0.05). The SOS of the two groups decreased but was significantly higher in the high-dose group compared to the low-dose group (p<0.05). Serum levels of IGF-1, IGFBP-3, and GH in both groups increased compared to the baseline values and were higher in the high-dose group than in the low-dose group (p<0.05). There was no significant difference in the incidence of adverse reactions between the high-dose group (8.6%) and the low-dose group (6.1%) (p>0.05).
High-dose rhGH treatment for GHD is safe and can more effectively upregulate IGF-1, IGFBP-3, and GH, and promote the growth and development of children.
方法:对我院2019年6月至2022年1月收治的174例GHD患者的病历进行回顾性分析。共有136名患者符合纳入标准,其中70例接受0.1U/(kg·d)(低剂量组),66例接受0.2U/(kg·d)剂量的rhGH治疗(高剂量组).生长发育状况[身高,体重,身高标准偏差(HtSDS),增长率],骨龄,骨密度,声速(SOS)作为桡骨远端骨量,生长和发育的生化指标[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)],比较两组患者治疗前后生长激素(GH)水平及不良反应发生率。
结果:治疗后,高度,体重,HTSDS,与治疗前相比,两组的生长速度均增加,高剂量组明显高于低剂量组(p<0.05)。经过一年的治疗,进行了以下观察:与基线值相比,两组的骨龄增加,高剂量组的骨龄高于低剂量组(p<0.05).两组SOS均降低,但高剂量组明显高于低剂量组(p<0.05)。与基线值相比,两组血清IGF-1、IGFBP-3和GH水平均升高,高剂量组高于低剂量组(p<0.05)。高剂量组(8.6%)与低剂量组(6.1%)不良反应发生率差异无统计学意义(p>0.05)。
结论:大剂量rhGH治疗GHD是安全的,可以更有效地上调IGF-1、IGFBP-3和GH,促进儿童的生长发育。