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    单用rhGH、GnRHa及联合应用对青春期早发育特发性矮身材患儿的疗效观察

    Effectiveness of rhGH, GnRHa or their combination in the treatment of early puberty in children with idiopathic short statue

    • 摘要: 目的 分析单用重组人生长激素(rhGH)与促性腺激素释放激素类似物(GnRHa)及二者联合使用治疗青春期早发育特发性矮身材患儿的近期疗效与安全性。方法 选取2017年9月—2019年6月于徐州医科大学附属医院治疗的青春期早发育特发性矮身材患儿作为研究对象,共60例。依据治疗方案的不同将患儿分成3组:单用rhGH治疗组、单用GnRHa治疗组、rhGH联合GnRHa治疗组,每组20例。定期监测身高、预测终身高(PAH);监测空腹血糖水平、甲状腺功能、肝功能及血清胰岛素样生长因子1(IGF-1)。结果 随访1年后,3组患儿身高、骨龄、PAH与治疗前比较,差异均有统计学意义(P<0.05)。rhGH联合GnRHa治疗组患儿的生长速度和PAH高于单用rhGH 治疗组和单用GnRHa治疗组,差异有统计学意义(P<0.05)。3组患儿治疗后未见明显血糖异常、肝功能异常及甲状腺功能异常等不良反应(P>0.05)。结论 rhGH与GnRHa联合治疗在提高生长速度、改善PAH方面的疗效优于单用rhGH或GnRHa治疗,治疗后无明显不良反应。

       

      Abstract: Objective To analyze the short-term effectiveness and safety of recombinant human growth hormone (rhGH), gonadotropin-releasing hormone analogue (GnRHa) or their combination in the treatment of early puberty children with idiopathic short stature (ISS). Methods A total of 60 early puberty children with ISS who were admitted to the Affiliated Hospital of Xuzhou Medical University from September 2017 to June 2019 were enrolled. According to their treatment strategies, they were divided into three groups (n=20): a rhGH treatment group, a GnRHa treatment group, and a combined treatment group. They were regularly monitored for their height, high predict lifetime (PAH); fasting glucose, thyroid function, liver function; serum insulin-like growth factor 1 (IGF-1). Results After 1 year of follow-up, children in the three groups produced statistical differences in height, bone age and PAH, compared with those before treatment (P<0.05). The combined treatment group produced remarkably higher growth rate and PAH than the rhGH treatment group and the GnRHa treatment group (P<0.05). There was no significant difference in blood glucose, thyroid function and liver function among the three groups (P>0.05). Conclusions The combined use of rhGH and GnRHa showed good effectiveness in increase growth rate and PAH improvement, which is superior to treatment with rhGH or GnRHa alone, without obvious adverse reactions.

       

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