重组人生长激素治疗特发性矮小患儿的临床研究

发布时间：2018-07-09 15:34

  本文选题：重组人生长激素 + 特发性矮小　； 参考：《中国临床药理学杂志》2017年10期

【摘要】：目的探讨重组人生长激素治疗特发性矮小(ISS)患儿的临床疗效及安全性及其与维生素D受体(VDR)启动子基因多态性的相关性。方法选取90例ISS患儿为试验组,90例同期体检健康的儿童为对照组。对照组未予以任何处理;试验组予以重组人生长激素0.15 U·kg~(-1),每晚一次,皮下注射,疗程为1年。用测序仪分析2组患儿VDR启动子中CDX-2结合位点rs11568820和rs4516035的基因型分布。比较2组患儿不同基因型下的生长速率(GV)、年龄对应身高标准差积分(Ht SDSCA)、骨龄对应身高标准差积分(Ht SDSBA)、预测成年身高(PAH),以及药物不良反应的发生情况。结果 rs11568820 GG型基因:试验组治疗前和治疗后的GV分别为每年(3.12±0.32),(9.61±1.01)cm;Ht SDSCA分别为(0.29±1.32)%,(0.93±0.12)%;Ht SDSBA分别为(0.10±0.15)%,(0.86±0.02)%;PAH分别为(149.02±3.18),(159.02±3.21)cm,差异均有统计学意义(均P0.05)。rs11568820 GA型基因:试验组治疗前和治疗后的GV分别为每年(2.92±1.21),(8.45±1.42)cm;Ht SDSCA分别为(0.42±0.15)%,(0.97±0.13)%;Ht SDSBA分别为(0.16±0.12)%,(0.83±0.13)%;PAH分别为(148.02±3.17),(156.02±3.09)cm,差异均有统计学意义(均P0.05)。rs11568820 AA型基因:试验组治疗前和治疗后的GV分别为每年(3.27±1.21),(8.21±1.43)cm;Ht SDSCA分别为(0.37±0.14)%,(0.82±0.14)%;Ht SDSBA分别为(0.19±0.26)%,(0.79±0.14)%;PAH分别为(149.37±2.91),(158.36±2.83)cm,差异均有统计学意义(均P0.05)。rs4516035 TT型基因:试验组治疗前和治疗后的GV分别为每年(2.71±1.63),(9.32±1.21)cm;Ht SDSCA分别为(0.35±0.21)%,(0.84±0.13)%;Ht SDSBA分别为(0.17±0.23)%,(0.76±0.13)%;PAH分别为(151.13±3.15),(158.23±2.86)cm,差异均有统计学意义(均P0.05)。rs4516035 CT型基因:试验组治疗前和治疗后的GV分别为每年(2.46±1.32),(8.46±1.46)cm;Ht SDSCA分别为(0.32±0.24)%,(0.89±0.13)%;Ht SDSBA分别为(0.17±0.14)%,(0.72±0.13)%;PAH分别为(149.34±3.29),(157.12±3.34)cm,差异均有统计学意义(均P0.05)。试验组发生的药物不良反应主要有血糖升高6例、膝部疼痛4例,其药物不良反应发生率为11.11%。结论 ISS与VDR启动子基因多态性无显著相关性,但与重组人生长激素治疗有明显的联系;重组人生长激素治疗ISS的临床疗效显著,且安全性较高。
[Abstract]:Objective to investigate the clinical efficacy and safety of recombinant human growth hormone (rhGH) in the treatment of children with idiopathic dwarf (ISS) and its association with vitamin D receptor (VDR) promoter gene polymorphism. Methods 90 patients with ISS were selected as control group. The control group was not treated with any treatment, and the experimental group was treated with recombinant human growth hormone 0.15 U kg-1, once a night, subcutaneously for one year. The genotypes of CDX-2 binding site rs11568820 and rs4516035 in VDR promoter were analyzed by sequencing. The growth rate (GV), age corresponding height standard deviation score (Ht SDSCA), bone age height standard deviation score (Ht SDSBA), adult height (PAH) and adverse drug reactions were compared between the two groups. Results rs11568820 GG type gene: GV before and after treatment were (3.12 卤0.32), (9.61 卤1.01) cm / year in the trial group, (0.29 卤1.32), (0.93 卤0.12), (0.10 卤0.15) in the test group, (149.02 卤3.18), (卤159.02 卤3.21) cm in the trial group, respectively. The difference was significant (all). Rs11568820 GA gene: before and after treatment, the difference was significant (all). Rs11568820 GA gene in the trial group was (149.02 卤3.18), (卤159.02 卤3.21) cm, respectively. 鍒嗗埆涓烘瘡骞，

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