中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2014年
12期
1816-1819
,共4页
程海英%刘晟%汪祝萍%尹燕丹%冯雪%陈瑾
程海英%劉晟%汪祝萍%尹燕丹%馮雪%陳瑾
정해영%류성%왕축평%윤연단%풍설%진근
生长激素,重组%婴儿,出生时低体重%胰岛素样生长因子Ⅰ%胰岛素样生长因子结合蛋白质3%身高
生長激素,重組%嬰兒,齣生時低體重%胰島素樣生長因子Ⅰ%胰島素樣生長因子結閤蛋白質3%身高
생장격소,중조%영인,출생시저체중%이도소양생장인자Ⅰ%이도소양생장인자결합단백질3%신고
Growth hormone%Infant,low birth weight%Insulin-like growth factor-Ⅰ%Insulin-like growth factorbinding protein3%Body height
目的 探讨血清胰岛素样生长因子1(IGF-1)、胰岛素样生长因子结合蛋白3(IGFBP-3)、两者比值及身高均值标准差积分(HtSDS)在重组人生长激素(rhGH)治疗小于胎龄儿(SGA)中的临床应用价值.方法 对32例确诊为追赶生长失败的SGA患儿应用rhGH治疗(0.15～0.20 u·kg-1·d-1),每晚睡前皮下注射,治疗3、6、9、12个月后进行随访,比较治疗前后的血清IGF-1、IGFBP-3,HtSDS、年生长速率(GV)的变化.结果 GV治疗前为(4.1 ±0.5)cm/年,治疗后3、6、9、12个月分别升至(12.4 ±3.2) cm/年、(11.0 ±2.3)cm/年、(10.1±3.5)cm/年、(9.4±1.8)cm/年,显示治疗后追赶生长明显(F=51.35,P＜0.01);HtSDS治疗前为(-2.81±0.64),治疗后分别为(-2.55 ±0.73)、(-2.39±0.65)、(-2.21±0.58)和(-2.09±0.94),显示治疗后身高与同年龄同性别正常儿童差距逐步缩小,与治疗前相比差异有统计学意义(F=4.99,P＜0.01).IGF-1、IGFBP-3明显升高,各监测时间点和治疗前相比差异有统计学意义(F=34.52、14.04,均P＜0.01),以IGF-1升高更明显,3个月之后维持在较高的水平,6个月达高峰;IGF-1/IGFBP-3比值和治疗前相比有所上升,但差异无统计学意义(F=1.82,P＞0.05).rhGH治疗6个月内,血清IGF-1和身高标准差积分相对治疗前的变化(△HtSDS)存在显著正相关(r3 =0.72,r6=0.91),9个月后不存在相关性(r9 =0.26,r12=0.33).治疗期间未发生严重不良事件.结论 rhGH治疗SGA后IGF-1、IGFBP-3升高,以IGF-1升高更明显,6个月内血清IGF-1和△HtSDS存在显著正相关,9个月后不存在相关.rhGH治疗小于胎龄儿是安全有效的.
目的 探討血清胰島素樣生長因子1(IGF-1)、胰島素樣生長因子結閤蛋白3(IGFBP-3)、兩者比值及身高均值標準差積分(HtSDS)在重組人生長激素(rhGH)治療小于胎齡兒(SGA)中的臨床應用價值.方法 對32例確診為追趕生長失敗的SGA患兒應用rhGH治療(0.15～0.20 u·kg-1·d-1),每晚睡前皮下註射,治療3、6、9、12箇月後進行隨訪,比較治療前後的血清IGF-1、IGFBP-3,HtSDS、年生長速率(GV)的變化.結果 GV治療前為(4.1 ±0.5)cm/年,治療後3、6、9、12箇月分彆升至(12.4 ±3.2) cm/年、(11.0 ±2.3)cm/年、(10.1±3.5)cm/年、(9.4±1.8)cm/年,顯示治療後追趕生長明顯(F=51.35,P＜0.01);HtSDS治療前為(-2.81±0.64),治療後分彆為(-2.55 ±0.73)、(-2.39±0.65)、(-2.21±0.58)和(-2.09±0.94),顯示治療後身高與同年齡同性彆正常兒童差距逐步縮小,與治療前相比差異有統計學意義(F=4.99,P＜0.01).IGF-1、IGFBP-3明顯升高,各鑑測時間點和治療前相比差異有統計學意義(F=34.52、14.04,均P＜0.01),以IGF-1升高更明顯,3箇月之後維持在較高的水平,6箇月達高峰;IGF-1/IGFBP-3比值和治療前相比有所上升,但差異無統計學意義(F=1.82,P＞0.05).rhGH治療6箇月內,血清IGF-1和身高標準差積分相對治療前的變化(△HtSDS)存在顯著正相關(r3 =0.72,r6=0.91),9箇月後不存在相關性(r9 =0.26,r12=0.33).治療期間未髮生嚴重不良事件.結論 rhGH治療SGA後IGF-1、IGFBP-3升高,以IGF-1升高更明顯,6箇月內血清IGF-1和△HtSDS存在顯著正相關,9箇月後不存在相關.rhGH治療小于胎齡兒是安全有效的.
목적 탐토혈청이도소양생장인자1(IGF-1)、이도소양생장인자결합단백3(IGFBP-3)、량자비치급신고균치표준차적분(HtSDS)재중조인생장격소(rhGH)치료소우태령인(SGA)중적림상응용개치.방법 대32례학진위추간생장실패적SGA환인응용rhGH치료(0.15～0.20 u·kg-1·d-1),매만수전피하주사,치료3、6、9、12개월후진행수방,비교치료전후적혈청IGF-1、IGFBP-3,HtSDS、년생장속솔(GV)적변화.결과 GV치료전위(4.1 ±0.5)cm/년,치료후3、6、9、12개월분별승지(12.4 ±3.2) cm/년、(11.0 ±2.3)cm/년、(10.1±3.5)cm/년、(9.4±1.8)cm/년,현시치료후추간생장명현(F=51.35,P＜0.01);HtSDS치료전위(-2.81±0.64),치료후분별위(-2.55 ±0.73)、(-2.39±0.65)、(-2.21±0.58)화(-2.09±0.94),현시치료후신고여동년령동성별정상인동차거축보축소,여치료전상비차이유통계학의의(F=4.99,P＜0.01).IGF-1、IGFBP-3명현승고,각감측시간점화치료전상비차이유통계학의의(F=34.52、14.04,균P＜0.01),이IGF-1승고경명현,3개월지후유지재교고적수평,6개월체고봉;IGF-1/IGFBP-3비치화치료전상비유소상승,단차이무통계학의의(F=1.82,P＞0.05).rhGH치료6개월내,혈청IGF-1화신고표준차적분상대치료전적변화(△HtSDS)존재현저정상관(r3 =0.72,r6=0.91),9개월후불존재상관성(r9 =0.26,r12=0.33).치료기간미발생엄중불량사건.결론 rhGH치료SGA후IGF-1、IGFBP-3승고,이IGF-1승고경명현,6개월내혈청IGF-1화△HtSDS존재현저정상관,9개월후불존재상관.rhGH치료소우태령인시안전유효적.
Objective To investigate the clinical value of serum insulin-like growth factor-1 (IGF-1),insulin-like growth factor-binding protein-3 (IGFBP-3) and mean height standard deviation score(HtSDS) in recombinant human growth hormone (rhGH)-treated small for gestational age (SGA) children.Methods 32 cases of SGA failed of catch-up growth were subcutaneously injected with rhGH every night before bed at a dose of 0.15-0.20u· kg-1 · d-1.And the variation of serum IGF-1,IGFBP-3,HtSDS,body height and growth velocity (GV) were monitored at 3,6,9 and 12 months of the treatment and compared.Results The GV (cm/years) increased to (12.4 ± 3.2),(11.0 ± 2.3),(10.1 ± 3.5),(9.4 ± 1.8) versus (4.1 ± 0.5) before treatment,suggesting a significant catch-up growth after treatment (F =51.35,P ＜ 0.01).Accordingly,HtSDS increased to (-2.55 ± 0.73),(-2.39 ± 0.65),(-2.21 ± 0.58),(-2.09 ± 0.94) versus (-2.81 ± 0.64),suggesting that height gaps were reduced compared to the normal children of the same age and sex after rhGH treatment (F =4.99,P ＜0.01).The serum levels of IGF-1,IGFBP-3 were significantly increased compared to pre-treatment (F =34.52,14.04,all P ＜ 0.01),especially for serum IGF-1,which maintained at a high level after 3 months of treatment and up to peak after 6 months.However,the ratio of IGF-1/IGFBP-3 showed no increase after treatment (F =1.82,P ＞ 0.05).There was a significant positive correlation between the serum level of IGF-1 and △HtSDS after the rhGH treatment within six months (r3 =0.72,r6 =0.91),while there was no correlation between them after 9 months (r9 =0.26,r12 =0.33).There were no serious adverse events during the rhGH treatment.Conelusion The serum levels of IGF-1,IGFBP-3 were significantly increased after the rhGH treatment,especially for serum IGF-1.There was a significant positive correlation between the serum level of IGF-1 and △HtSDS within six months,but not after 9 months.The rhGH treatment could be a safe and effective strategy for SGA children.
