2025 年第 10 期 第 20 卷

不同剂量重组人生长激素对特发性矮小症患儿的影响比较

Effects of different doses of recombinant human growth hormone on children with idiopathic short stature

作者：何娟1华婧超2范凡3袁博1

英文作者：He Juan1 Hua Jingchao2 Fan Fan3 Yuan Bo1

单位：1河北大学附属医院儿科，保定071000；2河北省邯郸市妇幼保健院新生儿三科，邯郸056000；3河北省保定市第一中心医院保健处，保定071030

英文单位：1Department of Pediatrics Affiliated Hospital of Hebei University Baoding 071000 China; 2Third Department of Neonatology Handan Maternal and Child Health Hospital Hebei Province Handan 056000 China; 3Department of Health Care Baoding No.1 Central Hospital Hebei Province Baoding 071030 China

关键词：特发性矮小症；重组人生长激素；胰岛素样生长因子结合蛋白3；网膜素1；甲状腺功能；糖脂代谢

英文关键词：Idiopathicshortstature;Recombinanthumangrowthhormone;Insulin-likegrowthfactorbindingprotein3;Omentin-1;Thyroidfunction;Glucoseandlipidmetabolism

• 摘要：

• 目的 探讨不同剂量重组人生长激素（rhGH）对特发性矮小症（ISS）患儿的影响。方法 选择2022年3月至2023年3月河北大学附属医院收治的ISS患儿95例，按照随机数字表法分为低剂量组［31例，0.26 mg/(kg·d)］、中剂量组［32例，0.35 mg/(kg·d)］和高剂量组［32例，0.41 mg/(kg·d)］。比较3组患儿生长情况、生长因子水平、甲状腺功能、糖脂代谢指标、骨代谢指标及不良反应发生情况。结果 治疗后，3组患儿身高、生长速率、身高标准差积分、胰岛素样生长因子结合蛋白3（IGFBP-3）、胰岛素样生长因子1水平均高于治疗前，且高剂量组均高于中剂量组和低剂量组（均P＜0.05）。治疗后，3组甲状腺功能指标与治疗前比较差异均无统计学意义，且3组间比较差异均无统计学意义（均P＞0.05）。治疗后，3组空腹胰岛素、甘油三酯、低密度脂蛋白胆固醇水平均低于治疗前（均P＜0.05），3组间糖脂代谢指标比较差异均无统计学意义（均P＞0.05）。治疗后，3组网膜素1、骨碱性磷酸酶水平均高于治疗前，且高剂量组均高于中剂量组和低剂量组［（64±7）mg/L比（57±7）、（57±8）mg/L；（161±18）U/L比（132±16）、（130±17）U/L］（均P＜0.05）。3组间不良反应发生率比较差异无统计学意义（P＞0.05）。结论 高剂量rhGH治疗ISS患儿效果更佳，对血清IGFBP-3、网膜素1水平影响较大，且3种剂量对患儿糖脂代谢和甲状腺功能的影响相当。

• Objective To investigate the effects of different doses of recombinant human growth hormone (rhGH) on children with idiopathic short stature (ISS). Methods A total of 95 children with ISS admitted to the Affiliated Hospital of Hebei University from March 2022 to March 2023 were selected, and they were divided into low-dose group ［31 cases, 0.26 mg/(kg·d)］, medium-dose group ［32 cases, 0.35 mg/(kg·d)］ and high-dose group ［32 cases, 0.41 mg/(kg·d)］ according to the random number table method. The growth status, growth factor levels, thyroid function, glucose and lipid metabolism indexes, bone metabolism indexes, and adverse reactions were compared among the three groups. Results After treatment, the height, growth rate, height standard deviation score, and levels of insulin-like growth factor binding protein 3 (IGFBP-3) and insulin-like growth factor 1 of the three groups were higher than those before treatment, and those in the high-dose group were higher than those in the medium-dose group and the low-dose group (all P＜0.05). After treatment, there was no significant difference in thyroid function indexes of the three groups and before treatment, and there was no significant difference among the three groups (all P＞0.05). After treatment, the levels of fasting insulin, triglyceride, and low-density lipoprotein cholesterol of the three groups were lower than those before treatment (all P＜0.05), and there were no statistically significant differences in the glucose and lipid metabolism indexes among the three groups (all P＞0.05). After treatment, the levels of omentin-1 and bone alkaline phosphatase of the three groups were higher than those before treatment, and those of the high-dose group were higher than those of the middle-dose group and the low-dose group［(64±7)mg/L vs (57±7), (57±8)mg/L；(161±18)U/L vs (132±16), (130±17)U/L］(all P＜0.05). There was no statistically significant difference in the incidence of adverse reactions among the three groups (P＞0.05). Conclusion High-dose rhGH has a better effect in the treatment of children with ISS, which has a great effect on serum IGFBP-3 and omentin-1 levels, and the three doses have similar effects on glucose and lipid metabolism and thyroid function in children.