Comparison Of The Efficacy Of Use RhGH Alone Or Combined GnRHa In The Treatment Of Adolescent Girls With Idiopathic Short Stature

Objective: After treatment with recombinant human growth hormone(rh GH)alone and rh GH combined with gonadotropin releasing hormone analogue(Gn RHa),the indexes of observation before and after treatment were analyzed.To evaluate the curative effect of different treatment methods on adolescent idiopathic short stature(ISS)girls,and to provide a method and reference for the clinical treatment of adolescent ISS girls.Methods: This study included 40 girls who visited the endocrinology department of our hospital from December 2014 to December 2017 and were diagnosed as adolescent ISS.All the enrolled children were given reasonable guidance such as exercise,diet and sleep.According to whether to use Gn RHa treatment,divided into single group(20 cases),combined group(20 cases).Collect the age at the beginning of the follow-up,height,(Ht),weight,(Wt),bone age,(BA),insulin-like growth factor-1(IGF-1)base This information;collect children’s parents’ height information;collect the third month,6 months,9 months,12 months of Ht,Wt,IGF-1 data;collect 6 months,9 months of BA data information.Calculating growth rate(GV),height standard deviation score(Ht SDS)and predicting adult height(PAH).Data were sorted out with Excel2007,statistical analysis was conducted with SPSS22.0 software,and measurement data were expressed.Independent sample T test was used for comparison between the two groups of measurement data that were subject to normal distribution;differential paired T test was used for comparison before and after treatment;Wilcoxon symbolic rank sum test was used for comparison between the two groups of measurement data that were not subject to normal distribution;data at different time points before and after treatment were repeated measurement data;repeated measurement anova was used for comparison between two groups.P <0.05 was considered statistically significant.Results: 1.There was no significant difference in Ht,PAH,age,BA,IGF-1,GV,Ht SDSCA and Ht SDSBA between the two groups at the beginning of treatment(P>0.05).2.The Ht,PAH and GV in the two groups were significantly higher than those before treatment(P < 0 05).There was no significant difference in Ht and GV between the two groups after treatment(P > 0 05).PAH in the combined group were higher than those in the single group,and the difference was statistically significant(P < 0.05).BA in the combined group was lower than that in the single group,and the difference was statistically significant(P < 0.05).3.The difference of IGF-1 in different time points before and after treatment was significant(F = 76.557,P <0.001)for single group,and the levels of IGF-1 in 3-month,6-month,9-month and 12-month treatment were higher than that before treatment(P <0.05).The level of IGF-1 in the 3-month,6-month,9-and 12-month period was statistically significant(P <0.05).In the combined group,the difference of IGF-1 in different time points before and after treatment was statistically significant(F = 72.305,P <0.00 1)The levels of IGF-1 in 3-month,6-month,9-month and 12-month treatment were higher than that before treatment(P <0.05),and the level of IGF-1 in the 3-month,6-month,9-and 12-month period was statistically significant(P <0.05).IGF-1 levels in the single group were higher than those in the combined group at 3,6,9 and 12 months after treatment,but the differences were not statistically significant(P>0.05).4.For single group,the changes of Ht SDSCA at different time points before and after treatment were significantly different(F = 19.699,P < 0.001).The Ht SDSCA of 3 months,6 months,9 months and 12 months after treatment was higher than that of pre-treatment.There was a significant difference in Ht SDSCA between 3 months,6 months,9 months and 12 months after treatment,but there was no significant difference(P > 0.05).For combined group,there was significant difference in the changes of Ht SDSCA at different time points before and after treatment(F = 10.90).5,P < 0.001),pairwise comparison showed that Ht SDSCA of 3 months,6 months,9 months and 12 months after treatment were significantly higher than those before treatment(P < 0 05),3 months,6 months of treatment,and 3 months and 6 months of treatment,the difference was statistically significant(P < 0 05).Ht SDSCA increased gradually between 9 months and 12 months,but there was no significant difference(P > 0.05).After 3 months,6 months,9 months and 12 months of treatment,the Ht SDSCA of singles group was higher than that of combined group,but there was no significant difference between the two groups(P > 0 05).5.For single group,there was significant difference in the changes of Ht SDSBA at different time points before and after treatment(F = 19.806,P < 0.001).The comparison between two groups showed that the Ht SDSBA of 6 months before treatment and 12 months after treatment were increased in turn.The difference was statistically significant(P < 0.05).For the combined group,the changes of Ht SDSBA at different time points before and after treatment were statistically significant(F = 60.292,P < 0.001).The comparison between the two groups showed that the Ht SDSBA of 6 months and 12 months before treatment was increased in turn,and the difference was statistically significant.Significance(P < 0.05).The Ht SDSBA in the combined group was higher than that in the single group at 6 months and 12 mohnths,and the difference was statistically significant(P < 0 05).Conclusions: 1.Both rh GH alone or rh GH combined with Gn RHa can effectively improve the height of adolescent girls with idiopathic short stature,leading to the predicted increase in adult height.2.The height gain of the combined group may be greater than that of the single group in long-term treatment.