Clinical Efficacy And Safety Of Different Doses Of Recombinant Human Growth Hormone In The Treatment Of Idiopathic Short Disease In Adolescent Patients

Object:To investigate the clinical efficacy and safety of different doses of recombinant human growth hormone in the treatment of adolescent idiopathic short stature（ISS）.Method:A total of 60 patients with adolescent ISS children who were treated with rh GH in the clinic of People`s Hospital of Ningxia Hui Autonomous Region from December 2018 to December 2020.They were divided into teratment group 1(0.17U.kg^-1.d-¹)with 30 cases and treatment group 2(0.20U.kg^-1.d-¹)with recombinant human growth hormone（rh GH）The treatment course lasted for 12months,and the observation time points were 3,6,9 and 12 months after treatment.The observation indexes were as bollows:height、weight、growth velocity（GV）、blood routine、liver and、kidney function、blood glucose、thyroid function、bone age、pituitary enhanced nuclear magnetic resonance（MRI）、uterine adnexal color Doppler ultrasound in girls、height-standard deviation score（Ht SDS）、predicted adult height（PAH）.Results:（1）The growth efficacy of rh GH therapy in children with ISS:Height of group 1 increased from（131.87±8.46）cm to（141.43±8.43）cm after 12months rh GH therapy;the GV increased from（4.23±0.49）cm/y to（9.57±1.71）cm/y;the Ht SDS-CA increased from-2.32±0.61 to-2.32±0.61;the Ht SDS-BA increased from-2.87±0.64 to-2.34±0.74;the PAH increased from（146.46±7.65）cm to（150.52±7.68）cm.Height of group 2 increased from（131.95±9.16）cm to（143.19±9.54）cm after 12 months rh GH therapy;the GV increased from（4.15±0.50）cm/y to（11.23±1.99）cm/y;the Ht SDS-CA increased from-2.71±0.65 to-1.87±0.85;the Ht SDS-BA increased from-2.71±0.65 to-1.87±0.85;the PAH increased from（147.75±7.67）cm to（153.21±7.86）cm.They were significant differences between before and after treatment in both groups（P<0.01）.（2）12 months after treatment,ΔGV（cm/y）、ΔHt SDS-CAandΔPAH in group 1 were 5.29±1.69、0.50±0.22、4.05±1.78,while in group 2 were 7.08±1.95、0.84±0.36、5.46±2.72.There were significant differences between the two group（P<0.01）.（3）The effect of rh GH decreased significantly when the epiphysis was close to closure.（4）There was no significant change in BMI and no serious adverse reactions before and after rh GH treatment in the two groups.Conclusion:（1）Rh GH therapy has a significant effect on adolescent children with ISS without obvious adverse reactions.（2）The curative effect of rh GH in the treatment group 2 was better than that in the treatment group1.,suggesting that the growth promoting effect of high dose of growth hormone was better.（3）The effect of rh GH decreased significantly when the bone age approached the time of epiphyseal closure,suggesting that rh GH therapy should be used in the treatment of adolescent ISS as early as possible.