生长激素可有效提高幼年特发性关节炎患者的身高

摘要 目的：生长激素对接受糖皮质激素治疗出现严重生长迟缓的幼年特发性关节炎的疗效和安全性

方法：纳入本项对照研究的全身型和多关节型患儿（22女，16男）平均年龄为10.1岁。18例患者（9女，9男，平均年龄10.5岁）接受每周0.2-0.33 mg/kg生长激素治疗，持续4年。20例患者（13女，7男，平均年龄9.6岁）作为未治疗对照组。

结果：治疗组身高平均增加1SD，而对照组减少0.7SD。疾病活动性标志物与生长速度标准差评分明显相关。一般来说，轻或中度病情和低剂量糖皮质激素的患者对生长激素的治疗反应明显好于病情活动者。没有发现不良反应事件。

结论：我们的研究结果表明，长期生长激素治疗对严重JIA患者有良好疗效。还需进一步的数据证实其疗效和安全性及其对最终身高的影响。

附原文：Abstract OBJECTIVE: To evaluate the efficacy and safety of growth hormone treatment in severely growth retarded children with juvenile idiopathic arthritis (JIA) receiving glucocorticoids. STUDY DESIGN: Children with systemic and polyarticular idiopathic arthritis (22 F, 16 M) with a mean age of 10.1 years were enrolled in this controlled study. Eighteen patients (9 F, 9M; mean age, 10.5 years) received growth hormone in a dose of 0.20 to 0.33 mg/kg body weight per week for 4 years. Twenty patients (13 F, 7 M; mean age, 9.6 years) served as an untreated control group. RESULTS: Mean improvement in height in the treated group was 1 SD, whereas the patients of the control group lost 0.7 SD. Disease activity markers correlated significantly with the mean growth velocity standard deviation score. In general, children with mild or moderate disease and lower comedication grew and responded better to growth hormone therapy than those with active disease. No adverse events were noted. CONCLUSION: Our data suggest that long-term growth hormone therapy has a beneficial effect in children with severe forms of JIA. Further data are needed to confirm the efficacy and safety of growth hormone and its effect on final height.

引自：Bechtold S, Ripperger P, H?fner R, Said E, Schwarz HP. Growth hormone improves height in patients with juvenile idiopathic arthritis: 4-year data of a controlled study. J Pediatr. 2009 Oct;143(4):512-9.