目的 探讨钙尔奇D辅助重组人生长激素(rhGH)治疗特发性矮身材(ISS)儿童的疗效及对骨代谢指标、胰岛素样生长因子-1(IGF-1)、25 羟维生素D[25-(OH)D]水平的影响。方法 选取2015年1月-2017年6月本院收治的90例ISS患儿(ISS组),随机分为观察组与对照组,每组45例。另选同期性别、年龄相匹配的健康体检患儿45例作为正常组。对照组采用rhGH治疗,观察组采用rhGH加用钙尔奇D治疗。观察两组患儿治疗前及治疗后6、12个月身高(Ht)、骨龄(BA)、生长速度(GV)、身高均值标准差积分(HtSDS)、BA与生活年龄比值(BA/CA)、血清骨代谢指标[骨钙素(OC)、Ⅰ型前胶原氨基端延长肽(P1NP)]及25-(OH)D水平,并与45例健康正常儿童(正常组)进行比较。结果 ISS组的BA、Ht、GV、HtSDS、BA/CA及血清OC、PICP、IGF-1、25-(OH)D水平均显著低于正常组(P<0.05);治疗6、12个月,观察组的BA、Ht、GV、HtSDS、BA/CA及血清OC、PICP、IGF-1、25-(OH)D水平较治疗前显著提高(P<0.05),对照组的25-(OH)D水平无明显变化(P<0.05),且观察组的Ht、GV、HtSDS、HtSDS、及血清OC、PICP、IGF-1、25-(OH)D水平均显著高于对照组(P<0.05)。结论 ISS患儿存在骨代谢异常及IGF-1、25-(OH)D低水平现象,钙尔奇D辅助治疗可改善患儿的骨代谢状态并提高IGF-1、25-(OH)D水平,从而改善生长状况
Abstract
Objective To analyze the efficacy of Calcium D combined with recombinant human growth hormone (rhGH) in the treatment of children with idiopathic short stature (ISS) and its effect on serum levels of bone metabolization indexes,insulin-like growth factor-1 (IGF-1),25-hydroxyvitamin D[25-(OH)D].Methods Totally 90 children with ISS (ISS group) in Zhengzhou Yihe Hospital Affiliated to Henan University from January 2015 to June 2017 were enrolled in this study,and were randomly divided into observation group and control group,with 45 cases in each group. The control group was treated with rhGH,the observation group was treated with rhGH and Calcium D. And 45 children taking physical examination matched by sex and age were selected as normal group. The height (Ht),bone age (BA),growth rate (GV),height standard deviation score (HtSDS),BA-to-chronological age (BA/CA) and serum levels of bone metabolization indexes[osteocalcin (OC),type I procollagen amino terminal prolongation peptide (P1NP)],IGF-1 and 25-(OH)D of observation group and control group were observed before treatment,6 and 12 months after treatment. The indexes were compared with normal group. Results The BA,Ht,GV,HtSDS,BA/CA and serum levels of OC,PICP,IGF-1,25-(OH)D in the ISS group were significantly lower than those in normal group (P<0.05). After 6 and 12 months of treatment,the BA,Ht,GV,HtSDS,BA/CA and serum levels of OC,PICP,IGF-1,25-(OH)D in the observation group significantly increased (P<0.05). However,the 25-(OH)D in control group did not change significantly (P>0.05). Moreover,the Ht,GV,HtSDS,HtSDS and serum levels of OC,PICP,IGF-1,25-(OH)D in the observation group were significantly higher than those in control group (P<0.05). Conclusions There is abnormal bone metabolism and low level of IGF-1 and 25-(OH)D in children with ISS. Calcium D adjuvant therapy can improve bone metabolization and increase serum levels of IGF-1 and 25-(OH)D,thereby improving growth development
关键词
特发性矮身材 /
钙尔奇D /
骨代谢 /
胰岛素样生长因子-1 /
25 羟维生素D
Key words
idiopathic short stature /
Calcium D /
bone metabolization /
insulin-like growth factor-1 /
25-(OH)D
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