Efficacy And Influencing Factors Of RhGH In The Treatment Of Children With Growth Hormone Deficiency

Objectives:Retrospective analysis was made on preschool children who were diagnosed with GHD in the Second Affiliated Hospital of Nanchang University from September2017 to November 2019 and received recombinant human growth hormone standard therapy for at least 6 months.In order to study the therapeutic effect of recombinant human growth hormone on children's growth hormone deficiency,the changes of Ht,GV and HtSDS in children with GHD after 6,12 and 24 months of treatment were analyzed,and the therapeutic effect of recombinant human growth hormone on children with GHD of different sexes and different bone ages was also analyzed.METHODS:From September 2017-November 2019,60 children(including 32 boys and 28girls)who were diagnosed with GHD and treated with rhGH in our hospital's children's growth and development specialist center were selected as the research subjects,including 40 children with continuous treatment time ?12 months and 20 children with continuous treatment time ?24 months.The basic data of each child were collected.The 60 children were treated with rhGH at 0.1U/(kg·d)and injected subcutaneously 30 min before sleep every night.According to bone age,36 cases were divided into < 8 years group and ?8 years group,a total of 24 cases.All the children returned to the hospital for follow-up visits every 3 months after their treatment.The growth and development professionals trained by the unified team measured the morning height(Ht)and weight(Wt)of the children with the same measuring tool,and recorded the body mass index(BMI),growth rate(GV)and height standard deviation score(Ht SDS).The fasting serum IGF-1,IGFBP-3 and related liver and kidney functions were detected in the next morning.Left hand bone age films were taken before treatment,12 months and 24 months respectively.Meanwhile,the changes of growth indexes of the two groups(< 8 years old and ?8years old)before and after treatment were compared.Results:1.after 6,12 and 24 months of treatment,Ht,GV and HtSDS of children with GHD were significantly higher than those before treatment,and the difference was statistically significant(p<0.05).BMI and BAI had no significant difference compared with those before treatment(P>0.05).2.The study found that ? Ht,? HtSDS and GV showed a decreasing trend every 3 months after treatment,and the curative effect in the previous 3 months was the best with statistical significance(P<0.05).3.Correlation analysis of ?HtSDS and related influencing factors at 12 months after treatment showed that ? HtSDS after 12 months of treatment had negative correlation with CA,BA and BAI before treatment,and had significant linear correlation(P<0.05),positive correlation with FPH,?HtSDS in the first 3 months and ?HtSDS in the first 6 months,and had significant linear correlation(P<0.05).4.Correlation analysis of ?HtSDS and related influencing factors at 24 months after treatment showed that ? HtSDS after 24 months of treatment had negative correlation with CA before treatment,BA before treatment and BAD before treatment,and had significant linear correlation(P < 0.05).There was a positive correlation with ?HtSDS in the first 3 months and ?HtSDS in the first 6 months,and there was a significant linear correlation(P<0.05).5.The average levels of IGF-1 and IGF-BP-3 water in children with GHD were significantly higher than those before treatment(P<0.001)at 6 months,12 months,18 months and 24 months respectively.6.comparing the bone age 8< years old group with ?8 years old group,Ht,GV and HtSDS in the two groups were significantly higher than before treatment(all p<0.05);The ? GV and ? HtSDS in the group younger than 8 years old are significantly higher than those in the group older than or equal to 8 years old,and the difference is statistically significant.7.There was significant difference in IGF-1 between sexual and female GHD children before treatment(P<0.01).but no significant difference in other indexes(P<0.05)The difference of IGF-1 was also statistically significant after 6 months of treatment(P<0.01).There was significant difference in IGF-1 and BAD indexes after12 months of treatment(P<0.01).There was no significant difference in otherindexes(P<0.05).After 6 months of treatment,compared with before treatment,the differences in Ht SDS,BMI SDS,GV and IGF-1 indexes of male children with GHD were statistically significant(P<0.05).There were significant differences in Ht SDS,GV and IGF-1 indexes among female children with GHD(P<0.05).After 12 months of treatment,compared with before treatment,there were significant differences in HtSDS,BMISDS,GV and IGF-1 value between male and female children with GHD(P<0.05).Conclusions:1.rhGH has significant effect on promoting growth of children's GHD,and the growth rate of height in the first year is the fastest.2.The younger the bone age at the beginning of treatment,the better the growth promoting effect of rhGH.3.In the first year of rhGH replacement therapy,there was no significant difference in growth response between girls and boys with pre-adolescent growth hormone deficiency.