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目的研究重组人生长激素(rhGH)在治疗因儿童或青少年颅咽管瘤(Craniopharyngioma,CP)术后所致身材矮小的疗效与安全性。方法回顾性分析2004年4月-2014年1月在北京协和医院内分泌科矮小门诊治疗的37例(男28例,女9例)CP术后患儿的随访资料。分析观察身高、身高标准差计数(HT SDS)、IGF-1标准差计数(IGF-1 SDS)、生长速度(Growth Velocity,GV)、胰岛素样生长因子l(IGF-1)、体质指数(BMI)、骨龄(Bone Age,BA)、骨成熟度(BA/CA)等生长指标的差异。结果 rhGH治疗组患儿治疗前的GV为每年(3.68±1.27)cm,血IGF-l水平为(49.98±24.82)μg/ml,身高SDS为(-3.81±1.63)。治疗12个月后GV增加到每年(10.79±1.89)cm,IGF-1水平达到(285.33±184.24)μg/ml,身高SDS增加到(-2.74±1.74),且均较治疗前有统计学意义(P<0.01)。非rhGH治疗组治疗前GV为每年(3.07±1.46)cm,IGF-1为(58.41±38.02)μg/ml,至12个月后的观察点时,GV为每年(3.10±1.80)cm,IGF-1为(72.63±49.93)μg/ml(P>0.05)。结论 rhGH替代治疗有助于CP术后患儿身高的改善,安全性肯定。
Objective To study the efficacy and safety of recombinant human growth hormone (rhGH) in the treatment of short stature caused by children or adolescents with craniopharyngioma (CP). Methods A retrospective analysis of follow-up data of 37 cases (28 males and 9 females) treated with CP in the Department of Endocrinology, Peking Union Medical College Hospital from April 2004 to January 2014 was performed. The height, standard deviation (HTS), IGF-1 SDS, growth velocity (GV), insulin-like growth factor 1 (IGF-1), body mass index ), Bone Age (BA) and bone maturity (BA / CA). Results Before treatment, the GV of rhGH treatment group was (3.68 ± 1.27) cm, the level of serum IGF-1 was (49.98 ± 24.82) μg / ml, and the height SDS was (-3.81 ± 1.63). GV increased to (10.79 ± 1.89) cm and the level of IGF-1 reached (285.33 ± 184.24) μg / ml after 12 months treatment, and the height SDS increased to (-2.74 ± 1.74), both of which were significantly higher than those before treatment (P <0.01). The GV in non-rhGH treatment group was (3.07 ± 1.46) cm and (58.41 ± 38.02) μg / ml respectively before treatment, and the annual GV was (3.10 ± 1.80) cm and IGF -1 was (72.63 ± 49.93) μg / ml (P> 0.05). Conclusion rhGH replacement therapy is helpful for the improvement of height and safety of children after CP.