聚乙二醇重组人生长激素治疗生长激素缺乏症患儿的临床效果及对脂代谢的影响

doi:10.3969/j.issn.1007-3205.2021.04.010

摘要/Abstract

摘要： 目的探讨聚乙二醇重组人生长激素（pegylated recombinant human growth hormone,PEG-rhGH）治疗生长激素缺乏症（growth hormone deficiency,GHD）患儿的临床效果及对脂代谢的影响。
方法选取GHD患儿60例，随机分为观察组31例和对照组29例。对照组应用常规营养治疗，观察组在常规营养治疗基础上加用PEG-rhGH，每周0.16~0.17 mg/kg皮下注射，疗程为6个月。于治疗前、治疗后6个月检测2组身高、体重、甲状腺功能［促甲状腺激素（thyrotropic hormone，TSH）、游离甲状腺素（free thyroxine index，FT4）、游离三碘甲状腺原氨酸（free triiodothyronine，FT3）、总甲状腺素（thyroxine，T4）、总三碘甲状腺原氨酸（triiodothyronine，T3）］、血脂［总胆固醇（total cholesterol，T-CHO）、高密度脂蛋白胆固醇（high density liptein cholesterol，HDL-C）、低密度脂蛋白胆固醇（low density liptein cholesterol，LDL-C）、三酰甘油（triglyceride，TG）］、胰岛素样生长因子1（insulin-like growth factor 1，IGF-1）、胰岛素样生长因子结合蛋白3（insulin-like growth factor binding protein 3，IGF-BP3）变化。
结果治疗6个月后，观察组身高、体重明显高于治疗前，明显高于对照组，差异有统计学意义（P＜0.05）。对照组身高、体重与治疗前比较差异无统计学意义（P＞0.05）。2组治疗前后组间和组内TSH、FT4、FT3、T4、T3水平比较差异均无统计学意义（P＞0.05）。观察组TG、T-CHO、LDL-C水平明显低于治疗前，明显低于对照组，差异有统计学意义（P＜0.05）；观察组HDL-C与治疗前比较差异无统计学意义（P＞0.05）；对照组TG、T-CHO、HDL-C、LDL-C水平与治疗前比较差异无统计学意义（P＞0.05）。观察组IGF-1、IGF-BP3水平明显高于治疗前，明显高于对照组，差异有统计学意义（P＜0.05）。对照组IGF-1、IGF-BP3水平与治疗前比较差异无统计学意义（P＞0.05）。
结论 PEG-rhGH治疗GHD患儿临床效果明显，可促进身高、改善体重，有明显促生长作用，改善脂代谢，对甲状腺功能无明显不良影响，安全性较高。

关键词: 侏儒症,垂体性, 聚乙二醇重组人生长激素, 治疗结果

Abstract: Objective To investigate the clinical effect of pegylated recombinant human growth hormone(PEG-rhGH) in the treatment of children with growth hormone deficiency(GHD) and its effect on lipid metabolism.
Methods Sixty children with GHD were randomly divided into observation group(n=31) and control group(n=29). The control group was treated with conventional nutrition therapy, and the observation group was supplemented with PEG-rhGH on the basis of conventional nutrition therapy by subcutaneous injection of 0.16-0.17 mg/kg per week for 6 months. The changes in height, weight and thyroid function ［thyrotropic hormone(TSH), free thyroxine index(FT4), free triiodothyronine（FT3), total thyroxine(T4), total triiodothyronine(T3)］, blood lipid profile total cholesterol(T-CHO), high density lipoprotein cholesterol(HDL-C) and low density lipoprotein cholesterol(LDL-C), triglyceride(TG), insulin-like growth factor 1(IGF-1) and insulin-like growth factor binding protein 3(IGF-BP3) of the two groups were measured before and at 6 months after treatment.
Results At 6 months after treatment, the height and weight of the observation group were significantly higher than those before treatment, and significantly higher than those of the control group, and the difference was statistically significant(P＜0.05). There was no significant difference in height and weight between two groups(P＞0.05). There was no significant intra-group or inter-group difference in TSH, FT4, FT3, T4, T3 levels before and after treatment(P＞0.05). The levels of TG, T-CHO, and LDL-C in the observation group were significantly lower than those before treatment, and significantly lower than those in the control group, with statistical significance(P＜0.05); No significant difference was noted in the HDL-C in the observation group before and after treatment(P＞0.05). The levels of TG, T-CHO, HDL-C, and LDL-C in the control group had no statistical significance compared with those before treatment(P＞0.05). The levels of IGF-1 and IGF-BP3 in the observation group were significantly higher than those before treatment and those in the control group(P＜0.05). The levels of IGF-1 and IGF-BP3 in the control group were not significantly different from those before treatment(P＞0.05).
Conclusion PEG-rhGH has obvious clinical effect in the treatment of children with GHD. It can improve height and weight, promote growth, improve lipid metabolism, and has no obvious adverse effect on thyroid function, with good safety.

Key words: dwarfism, pituitary, polyethylene glycol recombinant human growth hormone, treatment outcome

张蔷, 刘丽君, 张晓军, 侯晓娜, 崔佳, 刘海敬. 聚乙二醇重组人生长激素治疗生长激素缺乏症患儿的临床效果及对脂代谢的影响[J]. 河北医科大学学报, 2021, 42(4): 415-419，434.

ZHANG Qiang, LIU Li-jun, ZHANG Xiao-jun, HOU Xiao-na, CUI Jia, LIU Hai-jing. The curative effects of PEG-rhGH on children with growth hormone deficiency and its effect on blood lipid metabolism[J]. Journal of Hebei Medical University, 2021, 42(4): 415-419，434.

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聚乙二醇重组人生长激素治疗生长激素缺乏症患儿的临床效果及对脂代谢的影响

The curative effects of PEG-rhGH on children with growth hormone deficiency and its effect on blood lipid metabolism

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