[垂体生长激素缺乏症患者经生长激素替代治疗后最终身高的评价]。

Maria Korpal-Szczyrska, Bohdana Dorant, Halina Kamińska, Dorota Birkholz, Maciej Niedźwiecki
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引用次数: 0

摘要

背景:生长激素治疗已被用于儿童垂体生长激素缺乏症。结果提高了他们的身高速度,达到了一般人群正常范围内的成人身高。目的:评价儿童期生长激素缺乏症患者的最终身高,这些患者已经完成治疗,成年后仍然缺乏生长激素。材料和方法:诊断为生长激素缺乏症的儿童21例(男12例,女9例),给予生长激素治疗至最终身高,剂量为0.17 mg/kg/周(0.5 IU/kg/周),皮下注射7天。单纯GHD 7例,多发性垂体激素缺乏14例。结果:诊断时胰岛素耐量试验血清GH浓度为2.8+/-2.8 mU/l,可乐定试验血清GH浓度为3.3+/-2.2 mU/l。生长激素治疗后再次确认GH缺乏诊断,胰岛素耐量试验显示血清GH峰值为1.77+/-1.2 mU/l。治疗开始时患者的平均实足年龄为10.29+/-3.57岁,其中男孩明显高于男孩。患者完成一个疗程的实足年龄为17.85±1.97岁。儿童开始治疗时平均骨龄为7.24±3.57岁,结束时平均骨龄为15±0.97岁。治疗后,身高明显改善。治疗开始时的高度SDS为-4.03+/-0.91,治疗后的高度SDS为-0.69+/-1.01。在我们的患者中,最终身高和目标身高(-0.54+/-0.93 SDS)没有差异。结论:垂体生长激素缺乏症患儿经生长激素替代治疗后,最终身高在正常人群及目标身高范围内。
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[Evaluation of final height in patients with pituitary growth hormone deficiency who were treated with growth hormone replacement].

Background: Growth hormone (GH) therapy has been used for children with pituitary GH deficiency. It resulted in improving their height velocity and achieving an adult height in the normal range for the general population.

Objectives: To evaluate the final height in childhood-onset growth hormone deficiency patients who had already completed treatment and were still GH deficient in adult life.

Material and methods: 21 children (12 boys and 9 girls) diagnosed as GH deficiency and treated with growth hormone to final height at doses of 0.17 mg/kg/week (0.5 IU/kg/week) subcutaneously for 7 days. There were 7 patients with isolated GHD and 14 with multiple pituitary hormone deficiencies.

Results: At the diagnosis peak serum GH concentrations were 2.8+/-2.8 mU/l in insulin tolerance test and 3.3+/-2.2 mU/l in clonidine test. Reconfirmation of the GH deficiency diagnosis after growth hormone treatment revealed a peak serum GH 1.77+/-1.2 mU/l in insulin tolerance test. Mean chronological age of the patients at the beginning of treatment was 10.29+/-3.57 years and was significantly higher in boys. Patients had completed a course of treatment in the chronological age of 17.85+/-1.97 years. Children began treatment with mean bone age 7.24+/-3.57 years and ended with 15+/-0.97 years. After the treatment a significant improvement in height was shown. Height SDS at the beginning of the treatment was -4.03+/-0.91 and -0.69+/-1.01 after the treatment. There was no difference between final height and target height (-0.54+/-0.93 SDS) in our patients.

Conclusions: Children with pituitary growth hormone deficiency who were treated with growth hormone replacement achieve a final height in the normal range for the general population and their target height.

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[Evaluation of final height in patients with pituitary growth hormone deficiency who were treated with growth hormone replacement]. [Current views on the etiopathogenesis of goiter in children]. [Guidelines concerning insulin dosage in children and adolescents with type 1 diabetes on continuous subcutaneous insulin infusion]. [Familial precocious puberty -- a variant of norm or pathology?]. [Growth failure in a boy with Klinefelter syndrome and IUGR].
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