| 摘要: |
| 目的：探讨来曲唑在生长激素缺乏型矮小症男童的临床应用价值。方法：回顾性分析2016年3月至2018年6月安徽医科大学第二附属医院收治的80例生长激素缺乏型矮小症男童的临床资料，按治疗方案分为研究组和对照组各40例。对照组给予生长激素治疗，研究组在生长激素基础上加用来曲唑辅助治疗，均治疗2年，比较两组患儿治疗前、治疗1年、治疗2年的体格发育指标（身高、体质量、预测身高、生长速度）、骨龄、桡骨远端骨密度（SOS）、糖脂代谢指标[甘油三酯（TG）、总胆固醇（TC）、空腹血糖（FBG）、空腹胰岛素（FINS）]、血清胰岛素生长因子［胰岛素样生长因子结合蛋白-3（IGFBP-3）、胰岛素样生长因子-1（IGF-1）］、血清摄食抑制因子-1（nesfatin-1）、生长激素释放肽（ghrelin）水平，并监测不良反应发生情况。结果：两组治疗1年和2年的TC水平均低于治疗前，FBG、FINS水平均高于治疗前（P均<0.05）。研究组治疗1年和2年的身高、体质量、生长速度、SOS、IGFBP-3、IGF-1水平均高于对照组，nesfatin-1、ghrelin均低于对照组（P均<0.05）。两组不良反应发生率（研究组22.50%、对照组17.50%）比较差异无统计学意义（P>0.05）。结论：来曲唑辅助生长激素治疗生长激素缺乏型矮小症男童能进一步抑制血清nesfatin-1、ghrelin表达，上调血清IGFBP-3、IGF-1水平，促进患儿体格发育，且不会增加不良反应发生率，具有一定临床应用价值 |
| 关键词: 生长激素缺乏型矮小症 来曲唑 生长激素 体格发育 摄食抑制因子-1 生长激素释放肽 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2022.03.012 |
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| 基金项目: |
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| Clinical Value of Letrozole in the Adjuvant Treatment of Boys with Growth Hormone-Deficient Short Stature |
| Wang Qiang1,2, Niu Zhongpeng2 |
| (1. The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China; 2. Fuyang Hospital of Anhui Medical University, Anhui Fuyang 236000, China) |
| Abstract: |
| Objective: To probe into the clinical value of letrozole in the adjuvant treatment of boys with growth hormone-deficient short stature. Methods: Retrospective analysis was performed on the clinical data of 80 boys with growth hormone-deficient short stature admitted into the Second Affiliated Hospital of Anhui Medical University from Mar. 2016 to Jun. 2018. All patients were divided into the study group and the control group according to different treatment regimens, with 40 cases in each group. The control group was given growth hormone therapy, while the study group received letrozole combined with growth hormone therapy for 2 years. The physical development indicators (height, body weight, predicted height, growth rate), bone age, bone mineral density distal radius bone mass (SOS), glucose and lipid metabolism indicators such as triacylglycerol (TG), total cholesterol (TC), fasting blood glucose (FBG), fasting insulin (FINS), serum insulin growth factor such as insulin-like growth factor binding protein-3 (IGFBP-3) and insulin-like growth factor-1 (IGF-1), nesfatin-1, and ghrelin levels before treatment and after treatment of 1 year and 2 years were compared between two groups. The incidence of adverse drug reactions between two groups was recorded. Results: The levels of TC in two groups after treatment of 1 year and 2 years were lower than those before treatment, and the levels of FBG and FINS were higher than those before treatment (P<0.05). The height, body weight, growth rate, SOS, IGFBP-3 and IGF-1 levels in the study group were higher than those in the control group after treatment of 1 year and 2 years, while the nesfatin-1 and ghrelin levels were lower than those in the control group (P<0.05). There was no significant difference in the incidence of adverse drug reactions (22.50% in the study group and 17.50% in the control group) between two groups (P>0.05) Conclusion: Letrozole combined with growth hormone can further inhibit the expression of serum nesfatin-1 and ghrelin, up-regulate the serum levels of IGFBP-3 and IGF-1, and promote the physical development of boys with growth hormone-deficient short stature, with lower incidence of adverse drug reactions and higher clinical application value. |
| Key words: growth hormone-deficient short stature letrozole growth hormone physical development nesfatin-1 ghrelin |
