小于胎龄儿两年生长激素治疗的代谢和生长结果:一项回顾性研究。

Maria Cristina Savanelli, Rosario Ferrigno, Daniela Cioffi, Valeria Pellino, Antonella Klain
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引用次数: 0

摘要

背景:妊高症(SGA)新生儿如不及早进行追赶性生长,其生长速度、成年身高和代谢状况都会受到影响[1]。建议使用生长激素(GH)进行治疗,事实证明,生长激素对生长和代谢有积极影响,且耐受性良好[2]:方法:34 名 SGA 儿童(15 名女性,19 名男性;平均年龄:8.72 ± 2.48 岁)接受 GH 治疗(起始剂量:32.24 ± 2.88 mcg/kg/die),在 24 个月内每六个月对生长和代谢指标进行一次评估:两年后,SGA患儿的身高、体重和生长速度均有显著改善,6个月后已十分明显(p < 0.001),在整个治疗过程中,身高持续显著改善(p ≤ 0.03 T0 vs. T12,T12 vs. T24)。相反,虽然每次检查时身高都明显高于基线(p < 0.001),但从 6 个月到 18 个月,身高增长率明显下降(p ≤ 0.015 T6 vs. T12,T12 vs. T18)。在随访期间,观察到血糖升高(p ≤ 0.042 vs. T12, T18)和尿糖升高(p ≤ 0.01 vs. T12, T18, and T24),以及谷草转氨酶降低(p ≤ 0.021 vs. T12, T18, and T24)和低密度脂蛋白胆固醇降低(p = 0.03 vs. T24)。总体而言,治疗耐受性良好,最常见的不良反应是依从性差(11.8%),没有高血糖的报道:总之,GH 对 SGA 儿童是一种有效、安全的治疗方法,可改善身高和生长速度,但需要适当的代谢跟踪。
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Metabolic and Growth Outcome of Two-year Growth Hormone Treatment in Children Born Small for Gestational Age: A Retrospective Study.

Background: Children born Small for Gestational Age (SGA) without early catch-up growth may show impaired growth rate, adult height, and metabolic profile [1]. Growth Hormone (GH) is recommended for their treatment, and it has been shown to have positive effects on growth and metabolic profile and good tolerability [2].

Objective: The study aimed to evaluate the auxological and metabolic effects and safety of GH treatment in SGA children.

Methods: 34 SGA children (15 F, 19 M; mean age: 8.72 ± 2.48 yrs) treated with GH (starting dosage: 32.24 ± 2.88 mcg/kg/die) were evaluated every six months for 24 months with growth and metabolic parameters.

Results: After two years, SGA children showed a significant improvement in height, weight, and growth rate, already evident after six months (p < 0.001), with a constant, significant improvement in height throughout the treatment (p ≤ 0.03 T0 vs. T12, T12 vs. T24). Conversely, although significantly higher than baseline at each visit (p < 0.001), the growth rate significantly decreased from 6 to 18 months (p ≤ 0.015 T6 vs. T12, T12 vs. T18). During the follow-up, an increase in glycemia (p ≤ 0.042 vs. T12, T18) and urycemia (p ≤ 0.01 vs. T12, T18, and T24) and a decrease in AST (p ≤ 0.021 vs. T12, T18, and T24) and LDL cholesterol (p = 0.03 vs. T24) were observed. Overall, treatment was found to be well tolerated, with poor compliance being the most frequent adverse event (11.8%) and no reported hyperglycemia.

Conclusion: In conclusion, GH can be considered an effective, safe treatment in SGA children, improving height and growth rate, although proper metabolic follow-up is required.

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