矮身材患儿使用不同剂型生长激素治疗的效果及生活质量评估-现代医学

矮身材患儿使用不同剂型生长激素治疗的效果及生活质量评估

单位：1. 徐州医科大学淮安临床学院儿科, 江苏淮安 223300;
2. 南京医科大学康达学院附属涟水人民医院儿科, 江苏淮安 223400;
3. 徐州医科大学淮安临床学院检验科, 江苏淮安 223300

分类号：R725.8

出版年·卷·期（页码）：2024·52·第十期（1546-1551）

摘要：

目的： 观察矮身材患儿使用长、短效剂型生长激素治疗的效果及对生活质量的影响，为临床治疗方案的选择提供依据。方法： 采用密封信封法将入组的150例矮身材患儿随机分为对照组、长效治疗组及短效治疗组。对照组予规范的健康生活指导及营养支持治疗；长效治疗组每周1次皮下注射长效生长激素；短效治疗组每日1次皮下注射短效生长激素。连续治疗6个月，对3组患儿的临床疗效和生活质量进行评估。结果： 治疗6个月后，3组患儿的身高、身高标准差积分(HtSDS)、胰岛素样生长因子1(IGF-1)均较治疗前有所升高(均P<0.05)；长、短效治疗组身高，HtSDS，IGF-1明显高于对照组(P<0.05)；但长、短效治疗组之间各项数值差异均无统计学意义(均P>0.05)。3组患儿在治疗前后，甲状腺功能和空腹血糖值无明显变化，均维持在正常范围内(P>0.05)。与治疗前相比，对照组治疗后的生活质量差异无统计学意义(P<0.05)；长、短效治疗组患儿生活质量得分有所上升，且均高于对照组(均P<0.05)；但长、短效治疗组之间生活质量评分差异均无统计学意义(均P>0.05)。结论： 长、短效剂型生长激素治疗均同样有效改善矮身材患儿的身高及生活质量。

Objective: To compare the efficacy of long-acting and short-acting growth hormone therapies and their impact on the quality of life in children with short stature, providing a basis for clinical treatment selection. Methods: 150 children with short stature were randomly divided into the control group, the long-acting treatment group and the short-acting treatment group using the sealed-envelope method. The control group received standardized healthy life guidance and nutritional support treatment. The long-acting treatment group received subcutaneous injection of long-acting growth hormone once a week.The short-acting treatment group received subcutaneous injection of short-acting growth hormone once a day. The clinical efficacy and quality of life of the three groups were evaluated after 6 months of continuous treatment. Results: After 6 months, height, height standard deviation score(HtSDS), and insulin-like growth factor 1(IGF-1) of the three groups increased compared with those before treatment(all P<0.05),the long-and short-acting groups showed significantly greater improvements than those of the control group(all P<0.05).However,there were with no significant differences between the two treatment groups(all P>0.05). Thyroid function and fasting blood glucose remained unchanged and within normal limits(all P>0.05). After treatment, quality of life did not significantly improve in the control group(P>0.05), while it significantly increased in both treatment groups compared to the control(all P<0.05), with no significant difference between the long-and short-acting groups(all P>0.05). Conclusion: Both long-and short-acting growth hormone therapies are equally effective in improving height and quality of life in children with short stature.

参考文献：

[1] 欧阳力雪,杨凡.关注矮身材儿童心理健康[J].中国当代儿科杂志,2024,26(4):331-336.
[2] 张雪松,丁显春.学龄期矮小症患儿不良情绪与心理弹性的相关性[J].国际精神病学杂志,2020,47(6):1207-1209.
[3] 朱韬,熊菲.矮小儿童的神经心理状况研究进展[J].国际儿科学杂志,2024,51(3):168-173.
[4] 杨丽萍,宇根于,谢宇飞.重组人生长激素在儿童生长激素缺乏症和特发性矮小症治疗中的临床应用[J].中国药物与临床,2021,21(11):1849-1851.
[5] 王江珊,魏燕,于媛.剖宫产产妇唾液、血浆中催产素水平与产后抑郁的相关性[J].中国生育健康杂志,2024,35(3):253-257.
[6] 中华医学会儿科学会内分泌遗传代谢学组.矮身材儿童诊治指南[J].中华儿科杂志,2008,46(6):428-430.
[7] 朱艳丽,汤爱梅,谷奇,等.矮身材合并良性甲状腺结节患儿使用生长激素疗效观察[J].江苏大学学报(医学版),2023,33(4):338-342.
[8] 雷巧容,李自尊,宋芬芳,等.生长激素治疗对特发性矮小症患儿的影响分析[J].中国卫生标准管理,2022,13(18):11-14.
[9] LI F,LIU K,ZHAO Q,et a1.Prevalence of short stature among children in China:a systematic review[J].Pediatr Investig,2021,5(2):140-147.
[10] 步佳霖,温丙友,姚玲.重组人生长激素联合心理干预治疗特发性矮小症患儿的疗效及机制研究[J].中国现代医学杂志,2021,31(20):91-96.
[11] 任娟娟,任巧.rhGH治疗儿童生长激素缺乏症和特发性矮小症的疗效及影响因素研究[J].临床医学,2020,40(10):89-91.
[12] POUDEL S B,DIXIT M,NEGINSKAYA M,et al.Effects of GH/IGF on the aging mitochondria[J].Cells,2020,9(6):1384.
[13] 闻婷玉,朱翔,康冬梅.生长激素补充治疗对胰岛素样生长因子-1低减老年男性生活质量的影响及其安全性[J].中国老年学杂志,2020,40(19):4154-4157.
[14] 国家卫生健康委员会.国家卫生健康委关于印发健康儿童行动提升计划(2021—2025年)的通知[J].中华人民共和国国家卫生健康委员会公报,2021,(10):28-32.
[15] 张明英,钱莹,高龙,等.重组人生长激素对特发性矮小症患者的内分泌轴GHRH/GH/IGF-1的影响[J].哈尔滨医科大学学报,2022,56(1):47-50.
[16] 程洪源.生长激素治疗特发性矮小症的长效剂型和短效剂型临床疗效对比[J].中国科技期刊数据库医药,2023(12):77-80.
[17] 彭军,雷玲玲,杨柳,等.重组人生长激素治疗儿童特发性矮小症的效果及对糖脂代谢血清胰岛素样生长因子-1水平的影响[J]临床医学研究与实践,2022,7(32):82-85.
[18] 范婷婷,程昕然,鄢力,等.聚乙二醇重组人生长激素治疗生长激素缺乏症和特发性矮小症的疗效及安全性[J].中华全科医师杂志,2023,22(11):1167-1173.
[19] 张燕,蒋群.rhGH对青春期特发性矮小症患儿生长发育的影响[J].中国妇幼健康研究,2019,30(9):1133-1136.
[20] 郭艳艳,蒋成霞,姚兰,等.不同剂量重组人生长激素治疗对特发性矮小症患儿身高体重以及血清IGF-1和IGFBP-3表达的影响[J].解放军医药杂志,2020,32(3):44-47.
[21] 马梦瑾,罗臻臻,李志洁.重组人生长激素治疗特发性矮小症对患儿血清p21 waf/cip1 瘦素水平及生长情况的影响[J].中华生物医学工程杂志,2021,27(3):311-314.
[22] BLOEMEKE J,BALACANO VALDEZ R,MAURAS N,et a1.Psychometric performance of the quality of life in short stature youth(QoLISSY) questionnaire in a randomized open-label comparator trial in idiopathic short stature[J].J Pediatr Endocrinol Metab,2019,32(10):1089-1101.
[23] 曾佩佩,黄丽萍,邓梁琼,等.重组人生长激素治疗对特发性矮小症儿童心理状态影响的分析[J].中国儿童保健杂志,2021,29(1):71-74.
[24] 明庆森,张静,程长,等.催产素对男性品行障碍青少年共情能力的影响[J].中华行为医学与脑科学杂志,2021,30(10):887-891.
[25] KALYONCU T,ÖZBARAN B,KÖSE S,et al.Variation in the oxytocin receptor gene is associated with social cognition and ADHD[J].J Atten Disord,2019,23(7):702-711.
[26] UVNÄSMOBERG K,EKSTRÖMBERGSTRÖM A,BERG M,et al.Maternal plasma levels of oxytocin during physiological childbirtha systematic review with implications for uterine contractions and central actions of oxytocin[J].BMC Pregnancy Childbirth,2019,19(1):285.
[27] 张小甜,张悦,孙瑾,等.母亲唾液催产素水平与喂养方式和抑郁情绪的相关性研究[J].中华行为医学与脑科学杂志,2023,32(8):694-699.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录