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重组人生长激素在慢性腹膜透析儿童中的应用

  • ZHAI Yihui ,
  • XU Hong ,
  • SHEN Qian ,
  • et al
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  • 复旦大学附属儿科医院 上海市肾脏发育和儿童肾脏病研究中心(上海 201102)

网络出版日期: 2019-05-15

基金资助

2016年上海市卫生计生系统重要薄弱学科建设计划项目(儿科学)(No.2016ZB0101)

The treatment of recombinant human growth hormone for children on chronic peritoneal dialysis

  • 翟亦晖,徐虹,沈茜,等
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  • Division of Nephrology, Children’s Hospital of Fudan University, Shanghai Kidney Development & Pediatric Kidney Disease Research Center, Shanghai 201102, China

Online published: 2019-05-15

摘要

目的 研究重组人生长激素(rhGH)对慢性腹膜透析儿童身高增长的促进作用。方法 回顾分析2例经rhGH 治疗的慢性腹透患儿的相关临床资料。结果 2例女性患儿,分别于8岁8个月和9岁6个月时确诊尿毒症,并伴身材矮小。 经过第1年腹透及纠正酸中毒、贫血和电解质紊乱,改善营养和治疗肾性骨病等,例1身高SDS由-1.9增至-1.4,例2身 高SDS由-2.3减至-2.4。 2例患儿分别在9岁9个月和12岁3个月时开始rhGH治疗,开始治疗时2例患儿青春发育均属 于Tanner 1期。经过8个月的治疗,例1身高SDS由-1.3增加至-0.7,例2由-3.0增至-2.4;停止rhGH治疗8个月后, 例1身高SDS继续由-0.7增至-0.4,例2由-2.4增至-2.2。例1于rhGH治疗8个月期间身高增长7.5cm,rhGH治疗 停止8个月间身高增长减少为5.8 cm,例2身高增长则由9 cm降至4.5 cm。 结论 rhGH可提高腹膜透析治疗尿毒症患儿 的身高增长。

本文引用格式

ZHAI Yihui , XU Hong , SHEN Qian , et al . 重组人生长激素在慢性腹膜透析儿童中的应用[J]. 临床儿科杂志, 2019 , 37(5) : 381 . DOI: 10.3969/j.issn.1000-3606.2019.05.014

Abstract

Objective Growth retardation is a common and significant problem for children with end stage renal disease (ESRD). It has a serious impact on adult life and may increase mortality. Treatment of ESRD with dialysis may not completely successful in restoring normal growth. Recombinant human growth hormone (rhGH) may be an effective treatment for dialysis children to gain linear growth. The treatment of rhGH has not routinely been used for children on dialysis in China. We performed this retrospective analysis to study the effect of rhGH on improving linear growth of ESRD children on peritoneal dialysis (PD). Methods Clinical data of two ESRD children with chronic PD received rhGH treatment after exclusion of contraindication was retrospectively analyzed. The dose was 0.15 IU/kg iH qd x 6 days/week, for 8 months. Results Both patients were female with short stature at diagnosis of ESRD at the age of 8 years and 8 months and 9 years and 6 months, respectively. After one year of PD, case 1 experienced faster linear growth (Height SDS increased from -1.9 to -1.4). However, case 2 still had short stature (Height SDS decreased from -2.3 to -2.4). After 8 months of rhGH treatment, both cases had significantly increased growth velocity (P=0.014). Case 1 grew 7.5 cm during 8 months of rhGH treatment. Case 2 grew 9 cm during 8 months of rhGH treatment. After discontinuation of rhGH treatment for 8 months, the growth velocity of both cases significantly decreased again (P=0.042), although the height SDS still improved (Case 1, Height SDS increased from -0.7 to -0.4. Case 2, Height SDS increased from -2.4 to -2.2). Case 1 grew 5.8 cm 8 months after discontinuation of rhGH treatment, while case 2 grew 4.5 cm. Conclusion Uremia adversely affects linear growth of children. PD can partially improve the height growth. rhGH treatment can further increase the linear growth. No obvious side effects were observed in 8 months of rhGH treatment.
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