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河北医学  2020, Vol. 26 Issue (3): 374-378    DOI: 10.3969/j.issn.1006-6233.2020.03.006
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左甲状腺素片及生长激素治疗特发性矮小儿童疗效及对血清IGF-1和IGFBP-3水平影响
马勇, 王继锋, 张微
安徽省第二人民医院儿科, 安徽 合肥 230011
Effect of Levothyroxine Tablet and Growth Hormone for Idiopathic Short Children and the Influence on Serum IGF-1 and IGFBP-3 Levels
MA Yong, WANG Jifeng, ZHANG Wei
Anhui Second People's Hospital, Anhui Hefei 230011, China
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摘要 目的:研究左甲状腺素片与生长激素治疗特发性矮小儿童的临床疗效,及对患儿血清IGF-1和IGFBP-3水平的影响。方法:选取2014年6月至2018年7月于我院治疗的特发性矮小儿童110例进行研究,按照入院顺序奇偶性分为观察组(奇数组)与对照组(偶数组),每组55例;两组患儿在给予常规治疗方案的基础上,对照组给予重组人生长激素治疗,观察组给予左甲状腺片与重组人生长激素联合治疗,疗程为12个月;比较两组患儿生长效应、甲状腺功能、血清胰岛素样生长因子-1(IGF-1)和胰岛素样生长因子结合蛋白-3(IGFBP-3)水平及不良反应发生率。结果:两组患儿治疗第6、12个月的身高、体重、骨龄及生长速率较治疗前均显著上升(P<0.05),且观察组治疗第3、12个月的生长速率与治疗第12个月的体重均显著高于对照组(P<0.05);两组患儿治疗第6、12个月的血清游离三碘甲腺原氨酸(FT3)及血清游离甲状腺素(FT4)水平较治疗前均显著升高(P<0.05),观察组促甲状腺激素(TSH)水平显著上升(P<0.05),对照组TSH水平显著降低(P<0.05),且观察组治疗第3、6、12个月的FT4,治疗第6、12个月的FT3与对照组相比差异显著(P<0.05);两组患儿治疗第3、6、12个月的血清IGF-1和IGFBP-3水平较治疗前均显著升高(P<0.05),且观察组IGF-1水平与同时间点对照组相比差异显著(P<0.05);治疗期间,两组患儿不良反应发生率分别为10.91%和9.09%,不良反应发生率差异无统计学意义(P>0.05)。结论:与单用生长激素相比,左甲状腺素片与生长激素联合治疗特发性矮小儿童取得了较好的临床效果,且在一定程度上提升了患儿的生长效应,改善了甲状腺功能,增加了血清IGF-1和IGFBP-3水平。
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马勇
王继锋
张微
关键词 左甲状腺素片生长激素特发性矮小儿童    
AbstractObjective: To study the clinical efficacy of levothyroxine tablets and growth hormone in the treatment of idiopathic short stature in children, and the effects on serum IGF-1 and IGFBP-3 levels. Methods: A total of 110 children with idiopathic short stature admitted to our hospital from June 2014 to July 2018 were enrolled in the study. According to the parity of admission order, they were divided into observation group (odd array) and control group (even array). On the basis of conventional treatment regimen, control group was given recombinant human growth hormone therapy, and observation group was given levothyroxine tablets combined with recombinant human growth hormone, and they were treated for 12 months. The growth effects, thyroid function, levels of serum insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) and incidence rate of adverse reactions were compared between the two groups. Results: The height, weight, bone age and growth rate in the two groups on the 6th and 12th month of treatment were significantly higher than those before treatment (P<0.05), and the growth rate on the 3rd and 12th month of treatment and weight on the 12th month of treatment in observation group were significantly higher than those in control group (P<0.05). The level of thyroid stimulating hormone (TSH) on the 3rd, 6th and 12th month of treatment were significantly decreased in the two groups (P<0.05) while the levels of serum free triiodothyronine (FT3) and serum free thyroxine (FT4) were significantly increased (P<0.05), and the levels in observation group after treatment were significantly different compared with those in control group (P<0.05). The levels of serum IGF-1 and IGFBP-3 on the 3rd, 6th and 12th month of treatment in the two groups were significantly higher than those before treatment (P<0.05), and the level of IGF-1 in observation group was significantly different from that in control group at the same time (P<0.05). During treatment, the incidence rates of adverse reactions in the two groups were 10.91% and 9.09% respectively (P>0.05). Conclusion: Compared with growth hormone alone, levothyroxine tablets combined with growth hormone for idiopathic short stature in children has achieved better clinical results, and to some extent, it improves the growth effects, promotes thyroid function, and increases levels of serum IGF-1 and IGFBP-3.
Key wordsLevothyroxine tablets    Growth hormone    Idiopathic short stature in children
    
基金资助:安徽省卫生厅资助基金项目,(编号:2014013165)
引用本文:   
马勇, 王继锋, 张微. 左甲状腺素片及生长激素治疗特发性矮小儿童疗效及对血清IGF-1和IGFBP-3水平影响[J]. 河北医学, 2020, 26(3): 374-378.
MA Yong, WANG Jifeng, ZHANG Wei. Effect of Levothyroxine Tablet and Growth Hormone for Idiopathic Short Children and the Influence on Serum IGF-1 and IGFBP-3 Levels. HeBei Med, 2020, 26(3): 374-378.
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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2020.03.006     或     http://www.hbyxzzs.cn/CN/Y2020/V26/I3/374
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