Effect Of RhGH Treatment On Adult Height Of Children With ISS During Late Puberty

Growth hormone is a kind of peptide hormone excreted by the front part of pituitary. It is composed by 191 amino acids. It is the most functional hormone to help people grow after birth. It was phGH from human's pituitary that was first applied in medicine. It began to be tested in clinic treatment on children pituitary dwarfism since late 1950s(1958). The clinic application and its research develop very slowly because of the restriction of pituitary and the output of GH. The treatment cannot reach the demand of being as tall as other people for the exiguity of the leechdom or insufficiency of dosage or the short period of treatment. It was in mid 1980s that phGH was retracted from the markets because of the death happened on the treating children who died of neural disease and it was presumed that it had something to do with impuritily distilled phGH and contaminated with virus. Since then rhGH has been manufactured which is composed by recombinant techniques. rhGH totally substitutes phGH. The application area on GH grows quickly since 1985 when rhGH has been applied in clinic treatment instead of phGH. GH is applied not only in the treatment of pituitary dwarfism but also in the treatment of congenital agenesis of ovary, congenital achondroplasia ACH and intrauterirne growth retardation IUGR. About 2.3% of the children in China are ISS children. There has been no ideal treatment for a long time. The curative effect of rhGH to help growth in height caused by GHD has been recognized. rhGH can also accelerate the growth in height to non-GH shortage dwarfish children including ISS children. Many research abroad shows that GH can increase ISS children'adult height. Many parents of ISS children hope to increase their children's height. The well-known treatment is GH. The survey reports show that 94% of pediatric endocrine doctors will recommend GH treatment to the ISS children. Up to now, thousands of ISS children accepted being treated by GH. The ISS children usually have mental hindrance such as anxiety, depression, isolation to the society and hard to focus besides being dwarfish. This obfuscation may lead to the fall of children's school grades, the lack of communicative skill with others, and it may influence the satisfaction to life and working ability. It may even influence the application for jobs and marriage. The probability of problem behavior of ISS children reduces within the standard psychological test boundary. So rhGH treatment also heightens children's self-pride and the quality of healthy life while it increases ISS children's ultimate height. The treatment to the short stature is mainly based on explicit pathogenic. GH can treat both of the secondary short stature and the paroxysmal short stature. GH treatment for the lack of GH can reach the average common adult height within –2SD since the early 1980s when rhGH has been manufactured by using the recombinant DNA techniques. Treatment dosage: Most scholars recommend 0.1IU/kg/d, hypodermic before going to bed every night. The best effect is at the first 6 months to 12 months. It goes slow if applied for a longer period. Therefore the dosage can be added to 0.15IU/kg/d each time. But the total dosage shouldn't go beyond 0.2IU/kg/d. Nowadays, there are many reports abroad about rhGH on theIdiopathic short stature but there are few reports about the treatment on the late adolescent ISS children. And there are fewer in China. The American Food and Drug Administration agreed the GH treatment for the lack of GH on Idiopathic short stature. That is to say that the children who are extremely short but healthy can increase their height by injecting GH on July 25th 2003. But is rhGH effective to ISS Chinese children, especially to the late adolescent ISS children? There are very fewer clinic reports on that in China. This essay observed 40 cases on late adolescent ISS children whose height are at or below –2SD in late adolescent Tanner III---IV. There are two groups. One is comparative group and one is treating group. The treating group received the GH treatment, once a day, hypodermic for 6 months. The dosage is 0.15IU/kg/d. The treatment helped all the children in the treating group grow taller. The rate of growing is from 3.2cm±0.8cm/year before treatment to 6.9cm±1.2cm/year after treatment. The difference is obvious (p<0.05). While the growing rate in the comparative group is from 3.3cm±0.9cm/year to 2.8cm±0.7cm/year, there is no obvious difference. The prediction of adult height in the treating group is from 152.4±4.3cm before treatment 156.5±3.7cm after treatment. The difference is obvious (p<0.05). Compare with the two groups, the prediction of adult height increased from 152.1±4.1cm (comparative group) to 156.5±3.7cm (treating group), while there is no obvious difference in the comparative group before and after the observation. The bone age of the 20 children in the treating group for 6 months increases 0.63±0.5/year, while in comparative group, the bone age increases0.64±0.49/year. There is no obvious difference on bone age in the two groups. ( p>0.05). During the treatment, there was one patient who had slightly edema in his eyelids and lower legs. It disappeared after two to three weeks. There was no abnormity in blood, urine and kidney function. The patients had a recheck on thyroid gland function after 3 months. The function of sub-clinic thyroid gland reduced on two patients. The thyroid gland function turned normal after taking laevogyrate thyroxin. One patient had red swell on the spot of injecting. It disappeared after 3 days. The research shows that the most important judging guideline on whether GH helps children's growing height or not is the prediction to the children's adult height. The increased height now doesn't surely mean the increase of the adult height. If the height increases but the bone age increases faster, then the period of growing is shortened. The ultimate height on the contrary becomes lower; if the increase in height is faster than that in bone age, the ultimate height is increased. Therefore, the prediction to the increase of adult height is a good way to inspect the effect of the treatment. The result of the research shows rhGH is applied on the late adolescent ISS children for 6 months. The rate of growing each year and the prediction to the increase of adult height have been improved a lot. The increase of bone age is of no obvious difference. rhGH does help to grow in height, and it's effective and safe remedy.