目的 观察分析聚乙二醇重组人生长激素对特发性矮小症儿童的治疗效果及对血清p53及p21waf/cip1表达的影响,为临床合理应用提供依据。方法 选取2015年2月-2016年10月在本院接受治疗的121例特发性矮小症儿童作为研究对象,按照随机数字表法分为对照组和治疗组,其中对照组61例,治疗组60例,给予对照组常规营养治疗,治疗组在常规营养治疗基础上联合聚乙二醇重组人生长激素注射治疗,观察比较两组患者治疗效果和不良反应发生情况,治疗前、治疗后3个月、6个月以及治疗结束时IGF-1/IGFBP-3水平、血清p53以及p21waf/cip1表达水平差异。结果 疗程结束后,治疗组患者平均身高明显高于对照组(P<0.05);随着治疗时间延长,两组患者IGF-1和IGFBP-3水平均升高,与对照组相比,相同时间点治疗组IGF-1和IGFBP-3水平均明显高于对照组(P<0.05);治疗前后两组患者血清p53 mRNA水平差异无统计学意义(P>0.05);p21waf/cip1mRNA表达随着治疗时间延长不断降低,同一时间点治疗组显著低于对照组(P<0.05)。结论 聚乙二醇重组生长激素对特发性矮小症儿童的治疗效果显著,有效促进患者身高增高,改善细胞增殖受阻状况,具有在临床广泛应用的价值。

Objective To observe the treatment efficacy of polyethylene glycol recombinant growth hormone on idiopathic short stature children and its effect on the expression of p53 and p21waf/cip1. Methods A total of 121 children with idiopathic short stature treated in Ya′an Maternal and Child Health Care Planning Service Center from February 2015 to October 2016 were selected in this study and divided into control group (n=61) and treatment group (n=60) according to random number table method.The control group was treated with nutrition therapy, while the treatment group was treated with polyethylene glycol recombinant growth hormone in addition to nutritional therapy.The clinical efficacy and the adverse reactions incidence were observed, and the differences on IGF-1/IGFBP-3 as well as the expression of p53 and p21waf/cip1 before treatment, 3 months, 6 months after treatment were compared. Results The height of the treatment group was significantly higher than that of the control group after the treatment (P<0.05).The levels of IGF-1 and IGFBP-3 were increased with treatment time prolonged.The levels of IGF-1 and IGFBP-3 in the treatment group were significantly higher than those of the control group at the same point (P<0.05).There was no significant difference on the serum p53 mRNA levels between treatment group and control after treatment (P>0.05), while the expression level of p21waf/cip1 mRNA in the treatment group decreased with treatment time prolonged and it was significantly lower than that in the control group (P<0.05). Conclusions Polyethylene glycol recombinant human growth hormone has a significant therapeutic effect on idiopathic short stature children.And it is of great value in clinical application because of its efficacy in increasing the height of patients and improves cell proliferation.