史定平

    [摘要] 目的:找出GHD患儿使用rhGH治疗效果差的临床原因,及时纠正,保证疗效。方法:GHD患儿使用rhGH治疗,身高增长月平均15岁8例,月平均增高0.31 cm,复查甲状腺功能低下者4例。骨龄:15岁3例,月平均增高0.43 cm。3个月复查甲状腺功能低下者共18例,继续给左旋甲状腺素片口服。结论:GHD患儿使用rhGH治疗效果差的临床原因主要有合并甲状腺功能低下,纠正甲状腺功能低下可以改善疗效。年龄和骨龄越大,治疗效果越差,正确的诊断及正确的治疗是关键,基因的多态性和遗传性可能对疗效有影响。

    [关键词] GHD;疗效;甲状腺功能;骨龄;年龄

    [中图分类号] R584.2+1[文献标识码]A [文章编号]1673-7210(2009)08(c)-021-03

    Correcting of the poor therapeutic effect of rhGH in child patients with GHD

    SHI Dingping

    (Children Growth Expert Clinic, Beijing 100062, China)

    [Abstract] Objective: To find out the reasons of poor therapeutic effect of rhGH in children with growth hormone deficiency (GHD), rectify in time and certify the treatment effectiveness. Methods: Children with GHD, undergoing rhGH, with the increase of body height less than 1 cm per month were considered as poor therapeutic effect. 126 children with GHD, undergoing rhGH for 3 months [0.1 IU/(kg·d)] in our outpatient department from January 2006 to September 2008 were observed. Results: Selected 30 children with poor treatment effectiveness, 15 were boys and 15 were girls. The mean body height of this group was 139.6 cm [(130.6±35.6) cm] after the treatment of rhGH. The increase of body height per month was 0.77 cm, per 3 months was (2.4±0.6) cm. 1 case aged smaller than 7 years old, the increase of body height per month was 2.70 cm; 8 cases aged 7-12 years old, the increase of body height per month was 0.36 cm, 5 cases were received examination of thyroid hypofunction; 13 cases aged 13-15 years old, the increase of body height per month was 0.15 cm, 5 cases were received examination of thyroid hypofunction; 8 cases aged bigger than 15 years old, the increase of body height per month was 0.31 cm; 4 cases were received examination of thyroid hypofunction; 4 cases' bone age was smaller than 7 years old, the increase of body height per month was 0.67 cm, 1 case was received examination of thyroid hypofunction; 12 cases' bone age was 7-12 years old, the increase of body height per month was 0.24 cm, 8 cases were received examination of thyroid hypofunction; 11 cases' bone age was 13-15 years old, the increase of body height per month was 0.18 cm, 9 cases were received examination of thyroid hypofunction; 3 cases' bone age was bigger than 15 years old, the increase of body height per month was 0.43 cm. There were 18 children received examination of thyroid hypofunction after 3 months, went on using combination to treat. Conclusion: The reasons of poor therapeutic effect of rhGH in children with GHD are combination of thyroid hypofunction. The rectification of the thyroid hypofunction can improve therapeutic effect. The more older age and bone age, the more bad the therapeutic effect in child with GHD. The juncture is correct diagnosis and therapy. The therapeutic effect will be affected by polymorphism and polymorphism of gene. ......