CAJ | 학술논문

目的比较分析单纯促性腺激素释放激素类似物(GnRHa)或联合重组人生长激素(rhGH)治疗青春期非生长激素缺乏矮小(NGHDSS)患儿的助长疗效,探讨科学有效的青春期助长治疗方案.方法 42例青春期NGHDSS患儿(男性14,女性28),采用GnRHa联合rhGH治疗者(联合组)30例,单独GnRHa 治疗者(单治组)12例.GnRHa初始剂量100ug·kg-1·d-1(28 d),维持剂量60-80μg·kg-1·d-1(28d);rhGH初始剂量0.15 IU·ks-1·d-1(28 d),维持剂量0.10～0.15 IU·ks-1·d-1(28 d),疗程均为1-2年.主要观察各组年生长速率(GV)、对年龄的身高标准差分值(HtSDSCA)、对骨龄的身高标准差分值(HtSDSBA)、预测身高标准差分值(PAHSDS)的动态变化.结果 (1)1年疗效:联合组治疗前后比较,GV、HtSDSCA、HtSDSBA、PAHSDS变化均有统计学意义(均P<0.05).单治组患儿治疗前后比较,GV、HtSDSCA、HtSDSBA、PAHSDS变化均无统计学意义(均P>0.05).2组间比较,GV、HtSDSBA、PAHSDS均有显著性差异(均P<0.05).(2)2年疗效:联合组治疗前后比较,GV、HtSDSCA、HtSDSBA、PAHSDS变化均有统计学意义(均P<0.05).单治组治疗前后比较,GV、HtSDSCA、HtSDSBA、PAHSDS变化均无统计学意义(均P>0.05).2组间比较,GV、HtSDSBA、HtSDSCA、PAHSDS均有显著性差异(均P<0.05).结论采用GnRHa联合rhGH治疗青春发育初期的NGHDSS患儿能有效促进近期生长速率,其疗效明显优于单独GnRHa治疗,但对成年终身的贡献尚待研究.
목적 비교분석단순촉성선격소석방격소유사물(GnRHa)혹연합중조인생장격소(rhGH)치료청춘기비생장격소결핍왜소(NGHDSS)환인적조장료효,탐토과학유효적청춘기조장치료방안.방법 42례청춘기NGHDSS환인(남성14,녀성28),채용GnRHa연합rhGH치료자(연합조)30례,단독GnRHa 치료자(단치조)12례.GnRHa초시제량100ug·kg-1·d-1(28 d),유지제량60-80μg·kg-1·d-1(28d);rhGH초시제량0.15 IU·ks-1·d-1(28 d),유지제량0.10～0.15 IU·ks-1·d-1(28 d),료정균위1-2년.주요관찰각조년생장속솔(GV)、대년령적신고표준차분치(HtSDSCA)、대골령적신고표준차분치(HtSDSBA)、예측신고표준차분치(PAHSDS)적동태변화.결과 (1)1년료효:연합조치료전후비교,GV、HtSDSCA、HtSDSBA、PAHSDS변화균유통계학의의(균P<0.05).단치조환인치료전후비교,GV、HtSDSCA、HtSDSBA、PAHSDS변화균무통계학의의(균P>0.05).2조간비교,GV、HtSDSBA、PAHSDS균유현저성차이(균P<0.05).(2)2년료효:연합조치료전후비교,GV、HtSDSCA、HtSDSBA、PAHSDS변화균유통계학의의(균P<0.05).단치조치료전후비교,GV、HtSDSCA、HtSDSBA、PAHSDS변화균무통계학의의(균P>0.05).2조간비교,GV、HtSDSBA、HtSDSCA、PAHSDS균유현저성차이(균P<0.05).결론 채용GnRHa연합rhGH치료청춘발육초기적NGHDSS환인능유효촉진근기생장속솔,기료효명현우우단독GnRHa치료,단대성년종신적공헌상대연구.
Objective To assess the efficacy of gonadotropin-releasing hormone analogue(GnRHa)with or without recombinant human growth hormone(rhGH)treatment in Chinese short pubertal children with non-growth hormone deficiency.Methods Of 42 short pubertal children(14 males,28 females)without growth hormone deftcieney,the average age was(11.6±0.8)year.30 children were treated with slow release GnRHa with initial dose (100μg·kg-1·d-1,28d)and maintenance dose(60-80μg·kg-1·d-1,28d)labd rgGH with initial dose(0.15IU·kg-1·d-1)and maintenance dose(0.10-0.15IU·kg-1·d-1)for at least 1year.16 of them were still ongoing till the end of the second year.12 children were treated with GnRHa alone by initial dose(100μg·kg-1·d-1,28d)and maintenance dose (60-80μg·kg-1·d-1,28d),and 7 of them remained on it for 2 years.Dynamic changes including annual growth velocity(GV),bone age(BA)/chronologic age(CA)ratio,Tanner stage,height SDS for CA (HtSDSCA),height SDS for BA(HtSDSBA),and predicted adult height (PAHSDS)were observed.Results By the end of the first year tretment with combination therapy,the following parameters:GV,HtSDSCA,HtSDSBA,and PAHSDS all increased significantly(all P<0.05).Treatment with GnRHa alone did not yield significant changes in GV,HtSDSCA,HtSDSBA,and PAHSDS(all P>0.05).Changes in GV,HtSDSBA,and PAHSDS between these two groups were statistically significant(all P<0.05).By the end of the second year treatment,in the combination group,GV slowed from 6.7 to 5.5 cm/year(P<0.05).HtSDSCA,HtSDSBA,PAHSDS increased(all P<0.05).In the group with GnRHa treatment alone,GV slowed from 4.0 to 3.6 cm/year(P>0.05).HtSDSCA,HtSDSBA,PAHSDS increased(all P>0.05).Changes in GV,HtSDSCA,HtSDSBA,and PAHSDS between these 2 groups were statistically significant respectively(all P<0.05).Conclusion This combined treatment regimen significantly impreved the growth by increasing growth rate and delaying bone matumtion in pubertal chidren without growth hormone deficiency.Further study is needed to verify beneficial effects on the final height gain.