| Objective: To study the therapeutic effects of recombinant human growth hormone(rhGH)of growth hormone deficiency(GHD)and idiopathic short stature(ISS),and to establish a predictive model of rhGH efficacy.We want to investigate and compare the efficacy of rhGH and polyethylene glycol recombinant human growth hormone(PEG-rhGH)on children with GHD.Methods: From December 2016 to February 2018,a total of 141 outpatients of the General Hospital of Tianjin Medical University were included,and we would study their age,etiology and gender.A total of 103 patients were treated during the follow-up period of more than 6 months.Among them,15 children with PEG-rhGH were retrospectively collected,and 24 patients with a short-acting rhGH were prospectively collected.A retrospective study was conducted on 64 children with short-acting rhGH.64 patients were grouped according to different causes,including 38 cases of GHD and 26 cases of ISS.Height growth(ΔHt),growth velocity(GV),height standard deviation scores(HtSDS)and other indicators were observed.After variable screening,a multivariate linear regression method was used to establish a predictive model of height growth of rhGH,and 24 children were prospectively observed to verify the prediction model.According to the application of different growth hormone treatments,children with GHD were divided into rhGH group and PEG-rhGH group,and the effects of the two groups were studied and analyzed.rhGH group dose was 0.10-0.15U/kg/d,and rhGH subcutaneously was injected before every night.PEG-rhGH group dose was 0.20(mg/kg/w)and was injected subcutaneously once a week before going to bed.Results:1.The proportion of males and females with short stature was about 3:2.ISS accounts for about 49.62%,and GHD accounts for 44.44%.The age range was mostly 4 to 6 years old and 6 to prepuberty.2.Regardless of ISS or GHD,the growth index after treatment with rhGH was significantly higher than before,and the growth rate in the first 3 months of treatment was faster than that in 4-6 months after treatment.The difference was statistically significant(P<0.05).3.There was no significant difference in height growth between GHD and ISS after treatment with rhGH(P>0.05).4.We verified the model with twenty-four children.After 6 months of rhGH treatment,the measured and predicted growth rates were(10.70±3.08)cm/year,(11.57±1.76)cm/year,respectively.There was no significant difference(P>0.05).5.PEG-rhGH could also significantly improve the height of children with GHD,and the treatment growth index was higher than rhGH group.The difference was statistically significant(P <0.05).6.The growth rate in the first 3 months of PEG-rhGH treatment was faster than that in 4-6 months,but the difference was not statistically significant(P>0.05).7.Regardless of rhGH or PEG-rhGH treatment,fasting glucose(Glu)and insulin-like growth factor(IGF-1)showed an upward trend,and the differences were statistically significant(P<0.05).Conclusion:1.rhGH could effectively improve the height of children with GHD and ISS,and there was no difference in the therapeutic effect between them in the first 6 months.2.The effect of rhGH before 3 months was better than that of 4-6 months.3.PEG-rhGH could effectively improve the height of children with GHD,and the efficacy of treatment was not reduced.4.The prediction model was valuable on the clinical application.5.As a whole,PEG-rhGH and rhGH had no obvious adverse reactions and were all safe relatively. |
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