PDF(Pubmed)
Abstract：
Treatment outcomes for different causes of childhood dwarfism vary widely, and there are no studies on the economic burden of treatment in relation to outcomes. This paper compared the efficacy and healthcare costs per unit height of recombinant human growth hormone (rhGH) for the treatment of growth hormone deficiency (GHD) and idiopathic short stature (ISS) with a view to providing a more cost-effective treatment option for children. We retrospectively analyzed 117 cases (66 cases of GHD and 51 cases of ISS) of short-stature children who first visited Weifang People\'s Hospital between 2019.1 and 2022.1 and were treated with rhGH for 1 to 3 years to track the treatment effect and statistically analyzed by using paired t tests, non-parametric tests, and chi-square tests, to evaluate the efficacy of rhGH treatment for GHD and ISS children and the medicinal cost. The annual growth velocity (GV) of children with GHD and ISS increased the fastest during 3 to 6 months after treatment and then gradually slowed down. The GV of the GHD group was higher than that of the ISS group from 0 to 36 months after treatment (P < .05 at 3, 6, 9, and 12 months); the height standard deviation scores (HtSDS) of the children in the GHD and ISS groups increased gradually with the increase of the treatment time, and the changes in the height standard deviation scores (ΔHtSDS) of the GHD group were more significant than those of the ISS group (P < .05 at 3, 6, 9, and 12 months). (2) The medical costs in the pubertal group for a 1-cm increase in height were higher than those of children in the pre-pubertal group at the same stage (3 to 24 months P < .05). The longer the treatment time within the same group, the higher the medical cost of increasing 1cm height. RhGH is effective in treating children with dwarfism to promote height growth, and the effect on children with GHD is better than that of children with ISS; the earlier the treatment time, the lower the medical cost and the higher the comprehensive benefit.
摘要：
不同原因的儿童侏儒症的治疗结果差异很大，并且没有关于治疗的经济负担与结果相关的研究。本文比较了重组人生长激素（rhGH）治疗生长激素缺乏症（GHD）和特发性身材矮小（ISS）的疗效和单位身高的医疗保健成本，以期为儿童提供更具成本效益的治疗选择。我们回顾性分析了在2019.1年至2022.1年间首次到潍坊市人民医院就诊并接受rhGH治疗1至3年的117例（GHD66例，ISS51例）矮小儿童，以追踪治疗效果，并使用配对t检验进行统计学分析，非参数检验，和卡方检验，评估rhGH治疗GHD和ISS儿童的疗效和药物成本。GHD和ISS患儿的年生长速度（GV）在治疗后的3至6个月内增长最快，然后逐渐减慢。GHD组患儿治疗后0～36个月GV高于ISS组(3、6、9、12个月P<0.05);GHD组和ISS组患儿身高标准差评分(HtSDS)随治疗时间的增加逐渐升高,GHD组的身高标准差评分(ΔHtSDS)的变化较ISS组更为显著(3、6、9、12个月时P<0.05)。（2）青春期组儿童身高增加1cm的医疗费用高于青春期前组儿童在同一阶段的医疗费用（3至24个月P<0.05）。同组治疗时间越长，增加1cm身高的医疗费用越高。RhGH可有效治疗儿童侏儒症，促进身高增长，GHD患儿的疗效优于ISS患儿；治疗时间越早，医疗费用越低,综合效益越高。
