本文關(guān)鍵詞：特發(fā)性矮身材臨床相關(guān)因素觀察　出處：《河南科技大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 特發(fā)性矮身材 兒童 臨床相關(guān)因素 重組人生長激素

【摘要】：目的了解兒童特發(fā)性矮身材(ISS)的臨床相關(guān)因素;觀察基因重組人生長激素(r-h GH)的臨床療效及安全性,探討r-hGH的促生長療效與血清胰島素樣生長因子-1(IGF-1)、胰島素樣生長因子結(jié)合蛋白-3(IGFBP-3)的關(guān)系。方法1.使用自擬“特發(fā)性矮身材兒童相關(guān)因素調(diào)查表”回顧性調(diào)查我院近4年診治的ISS兒童144例,對臨床相關(guān)因素進行描述性分析;2.選取接受rhGH治療劑量為(0.15IU/kg·d)達(dá)12個月的ISS兒童67例,分別在治療前及治療后的每3個月測定身高、體重、空腹血糖、甲狀腺功能、IGF-1及IGFBP-3等,治療前及治療后的每6個月測定骨齡,并使用自擬的“特發(fā)性矮身材兒童接受r-h GH治療的隨訪表”進行記錄;3.進行統(tǒng)計學(xué)處理:采取方差齊性檢驗、重復(fù)測量的方差分析、秩和檢驗及線性相關(guān)性分析等方法研究r-hGH的臨床療效、安全性及其促生長療效與IGF-1、IGFBP-3的關(guān)系。結(jié)果1.描述性分析:(1)基本情況:144例患兒中男84例,女60例,性別比為1.4:1;年齡3~16歲,中位數(shù)9.1歲。就診年齡:以6歲~11歲為主,占52.78%;農(nóng)村兒童占44.44%;(2)父母情況:父親身高P25~P50的占38.19%,身高≤P25的占33.33%;母親身高P25~P50的占36.11%,身高≤P25的占43.05%;(3)ISS兒童生活習(xí)慣:入眠時間在11:30之后占47.22%;挑食、偏食占54.86%;每天運動量小于30min者占61.11%;2.ISS兒童接受r-hGH治療后身高及生長速率較前提高,差異有統(tǒng)計學(xué)意義(P0.05);體重及骨齡未見明顯快速增長,差異無統(tǒng)計學(xué)意義;不良反應(yīng)發(fā)生率為17.91%,對癥處理后均恢復(fù)正常。3.ISS兒童治療3、6、9、12月的IGF-1及IGFBP-3均較治療前增加,差異有統(tǒng)計學(xué)意義(P0.05);治療前IGF-1及IGFBP-3與治療后3月、6月、9月、12月的生長速率增加量呈負(fù)相關(guān)(P0.05);治療后3月、6月、9月、12月IGF-1及IGFBP-3增加量與同期生長速率增加量均呈正相關(guān)。結(jié)論1.本調(diào)查中ISS兒童多來自農(nóng)村;父母身高以中等偏下居多;父母受教育程度以初高中、職業(yè)以農(nóng)民及個體戶居多;存在不良飲食習(xí)慣、入眠時間在23:30以后、每日運動量小于30分鐘者占多數(shù);2.觀察期內(nèi)r-hGH治療ISS療效肯定,未發(fā)現(xiàn)嚴(yán)重影響患兒生活質(zhì)量的安全性問題;3.IGF-1及IGFBP-3對預(yù)測r-h GH治療ISS的療效的有一定的價值。
[Abstract]:Objective to understand the children with idiopathic short stature (ISS) clinical related factors; effect of recombinant human growth hormone (R-H GH) the clinical efficacy and safety of r-hGH, the growth promoting effect of serum insulin-like growth factor -1 (IGF-1), insulin-like growth factor binding protein -3 (IGFBP-3) relationship. Methods 1. made by the related factors of idiopathic short stature children were retrospectively investigated in recent 4 years in our hospital diagnosis and treatment of 144 children with ISS were analyzed by descriptive analysis of clinical related factors; 2. were treated with rhGH doses (0.15IU/kg - D) for 12 months up to 67 children with ISS before treatment, respectively and after treatment every 3 months for measuring height and weight, fasting blood glucose, thyroid function, IGF-1 and IGFBP-3, before and after treatment every 6 months for determination of bone age, and use the self-made "idiopathic short stature children underwent R-H GH treatment follow-up table records; 3. were: take the test of homogeneity of variance, repeated measures ANOVA, rank sum test and linear correlation analysis were used to study r-hGH clinical efficacy, safety and growth promoting effect and IGF-1, IGFBP-3 relationship. Results 1. descriptive analysis: (1) the basic situation: 144 cases of children 84 cases, female 60 cases, sex ratio is 1.4:1; age 3~16 years, median 9.1 years. Age: 6 years old ~11 years old, accounting for 52.78%; rural children accounted for 44.44%; (2) parents: father height P25~P50 accounted for 38.19%, accounting for 33.33% of the height less than P25; height of mother P25~P50 accounted for 36.11%, accounting for 43.05% of the height is less than or equal to P25; (3) ISS children's life habit: sleep time accounted for 47.22% after 11:30; partial eclipse picky eaters, accounted for 54.86%; amount of exercise every day is less than 30min accounted for 61.11%; 2.ISS children treated with r-hGH height and the growth rate is increased, the difference was statistically significant (P0.05); no significant weight and bone age of rapid growth, the difference was not statistically significant; the incidence rate of adverse reaction was 17.91%, after symptomatic treatment. All returned to normal. IGF-1 and IGFBP-3 3.ISS, 6, 9 children in 3 and December were compared with those before treatment, the difference was statistically significant (P0.05); IGF-1 and IGFBP-3 before treatment and after treatment, the growth rate in March June and September December, the increase was negatively correlated (P0.05); March, June, September after treatment, December IGF-1 and IGFBP-3 increase with the same growth rate increase was positively correlated. Conclusion the 1. survey of ISS children from rural areas; parents height to moderate majority; parental education in junior high school and senior high school, occupation to the majority of farmers and self-employed; there are unhealthy eating habits, sleep time after 23:30, the daily amount of exercise for less than 30 minutes of majority; 2. in the observation period of r-hGH treatment of ISS curative effect no, seriously affect the safety of children's quality of life is found; 3.IGF-1 and IGFBP-3 have certain value in predicting the efficacy of the treatment of ISS R-H GH.
【學(xué)位授予單位】：河南科技大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R725.8

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本文編號：1347461