Efficacy And Safety Of Short-acting Recombinant Human Growth Hormone On Growth And Development In Children With Turner Syndrome

Objectives:By observing the clinical manifestations of children with Turner syndrome admitted to Shanxi Children’s Hospital,the effect of short-acting rhGH on promoting height growth in children with Turner syndrome was investigated,and the effect of rhGH on fasting blood glucose,thyroid function and other related indexes in TS children during the treatment process was investigated,so as to provide the basis for the clinical treatment of children with Turner syndrome.Methods:Twenty cases of TS children admitted to Shanxi Children’s Hospital from December 2018 to December 2020 were selected,and relevant clinical data were collected.By observing the clinical manifestations of the children and analyzing the chromosomal karyotype in their peripheral blood,the disease was further diagnosed.After diagnosis,if the patient has masculine manifestations or marked chromosomes,SRY or Y chromosome detection is required to investigate the possibility of gonadal,adrenal or midline tumors.If so,laparoscopic prophylactic gonadectomy is required first,followed by Rh GH treatment;If the patients have no male manifestations or labeled chromosomes,they can be directly treated with rhGH by subcutaneous injection of short-acting rhGH 0.15IU/(kg·d),once a night.After treatment,they will go to the endocrine clinic of Shanxi Children’s Hospital for re-examination every 3 months.Height,weight,HTSDS,GV,IGF-1,thyroid function and fasting blood glucose of the children were monitored at 3 months,6 months and 12 months after treatment.Relevant data were collected to observe the changes of data before and after treatment,and statistical analysis was conducted.Results:1.The univariate repeated measurement analysis of variance showed that the differences in GV of TS children were statistically significant(F=72.65,P < 0.001)before and after treatment(11.09±3.29),(9.95±2.38)and(8.43±1.55)months after treatment(P < 0.05).The level of IGF-1 was significantly different before treatment and3,6 and 12 months after treatment(F=50.93,P < 0.001).Compared with before treatment,IGF-1 was increased at 3 months,6 months and 12 months after treatment(273.54±92.93,319.06±90.96,and 398.22±128.35)(P < 0.05).The difference of HTSDS level before and 3,6 and 12 months after treatment was statistically significant(F=27.69,P < 0.001).Compared with that before treatment,HTSDS level increased at 3months after treatment(-4.62±1.39),6 months after treatment(-4.42±1.45)and 12 months after treatment(-4.28±1.57)(P < 0.05).2.According to the results of variance analysis of repeated two-factor measurements,45 children with TS karyotype X and children with other karyotypes had statistically significant overall mean levels of GV,IGF-1 and HTSDS before and after treatment(GV: F=1.003,P=0.385;IGF-1: F=0.484,P=0.599;HTSDS: F=1.056,P=0.384).3.According to the ANOVA results of single factor repeated measurement,the overall mean of FT3,FT4,TSH and FPG values before and 3,6 and 12 months after rhGH treatment was not statistically significant(P > 0.05).Conclusion:1.The levels of GV,HTSDs and IGF-1 in TS children treated with rhGH increased compared with those before treatment,suggesting that rhGH treatment has a growth-promoting effect on TS children.2.Before and after rhGH treatment,there was no statistical significance in GV,IGF-1 and HTSDS levels of TS children with different karyotypes.3.Rh GH treatment had no significant effect on the fasting blood glucose and thyroid function of TS children,and no serious adverse reactions were observed during the treatment.