聚乙二醇重组生长激素治疗特发性矮小症儿童效果及对血清p53及p21waf/cip1表达的影响
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摘要
目的观察分析聚乙二醇重组人生长激素对特发性矮小症儿童的治疗效果及对血清p53及p21waf/cip1表达的影响,为临床合理应用提供依据。方法选取2015年2月-2016年10月在本院接受治疗的121例特发性矮小症儿童作为研究对象,按照随机数字表法分为对照组和治疗组,其中对照组61例,治疗组60例,给予对照组常规营养治疗,治疗组在常规营养治疗基础上联合聚乙二醇重组人生长激素注射治疗,观察比较两组患者治疗效果和不良反应发生情况,治疗前、治疗后3个月、6个月以及治疗结束时IGF-1/IGFBP-3水平、血清p53以及p21waf/cip1表达水平差异。结果疗程结束后,治疗组患者平均身高明显高于对照组(P<0.05);随着治疗时间延长,两组患者IGF-1和IGFBP-3水平均升高,与对照组相比,相同时间点治疗组IGF-1和IGFBP-3水平均明显高于对照组(P<0.05);治疗前后两组患者血清p53mRNA水平差异无统计学意义(P>0.05);p21waf/cip1mRNA表达随着治疗时间延长不断降低,同一时间点治疗组显著低于对照组(P<0.05)。结论聚乙二醇重组生长激素对特发性矮小症儿童的治疗效果显著,有效促进患者身高增高,改善细胞增殖受阻状况,具有在临床广泛应用的价值。
Objective To observe the treatment efficacy of polyethylene glycol recombinant growth hormone on idiopathic short stature children and its effect on the expression of p53 and p21 waf/cip1. Methods A total of 121 children with idiopathic short stature treated in Ya′an Maternal and Child Health Care Planning Service Center from February 2015 to October 2016 were selected in this study and divided into control group(n=61)and treatment group(n=60)according to random number table method.The control group was treated with nutrition therapy,while the treatment group was treated with polyethylene glycol recombinant growth hormone in addition to nutritional therapy.The clinical efficacy and the adverse reactions incidence were observed,and the differences on IGF-1/IGFBP-3 as well as the expression of p53 and p21 waf/cip1 before treatment,3 months,6 months after treatment were compared. Results The height of the treatment group was significantly higher than that of the control group after the treatment(P<0.05).The levels of IGF-1 and IGFBP-3 were increased with treatment time prolonged.The levels of IGF-1 and IGFBP-3 in the treatment group were significantly higher than those of the control group at the same point(P<0.05).There was no significant difference on the serum p53 mRNA levels between treatment group and control after treatment(P>0.05),while the expression level of p21 waf/cip1 mRNA in the treatment group decreased with treatment time prolonged and it was significantly lower than that in the control group(P<0.05). Conclusions Polyethylene glycol recombinant human growth hormone has a significant therapeutic effect on idiopathic short stature children.And it is of great value in clinical application because of its efficacy in increasing the height of patients and improves cell proliferation.
Objective To observe the treatment efficacy of polyethylene glycol recombinant growth hormone on idiopathic short stature children and its effect on the expression of p53 and p21 waf/cip1. Methods A total of 121 children with idiopathic short stature treated in Ya′an Maternal and Child Health Care Planning Service Center from February 2015 to October 2016 were selected in this study and divided into control group(n=61)and treatment group(n=60)according to random number table method.The control group was treated with nutrition therapy,while the treatment group was treated with polyethylene glycol recombinant growth hormone in addition to nutritional therapy.The clinical efficacy and the adverse reactions incidence were observed,and the differences on IGF-1/IGFBP-3 as well as the expression of p53 and p21 waf/cip1 before treatment,3 months,6 months after treatment were compared. Results The height of the treatment group was significantly higher than that of the control group after the treatment(P<0.05).The levels of IGF-1 and IGFBP-3 were increased with treatment time prolonged.The levels of IGF-1 and IGFBP-3 in the treatment group were significantly higher than those of the control group at the same point(P<0.05).There was no significant difference on the serum p53 mRNA levels between treatment group and control after treatment(P>0.05),while the expression level of p21 waf/cip1 mRNA in the treatment group decreased with treatment time prolonged and it was significantly lower than that in the control group(P<0.05). Conclusions Polyethylene glycol recombinant human growth hormone has a significant therapeutic effect on idiopathic short stature children.And it is of great value in clinical application because of its efficacy in increasing the height of patients and improves cell proliferation.
引文
[1]吴迪,冯国双,巩纯秀.生长激素治疗特发性矮小儿童随访至接近成年终身高的治疗效果分析[J].首都医科大学学报,2018,39(1):92-97.
[2]Cohen LE.Idiopathic short stature:a clinical review[J].Jama,2014,311(17):1787-1796.
[3]区远赵,黄诚花,陈秀英,等.重组人生长激素治疗儿童生长激素缺乏症和特发性矮小症的安全性分析[J].中国实用医药,2017,12(13):87-89.
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[5]栾斌.儿科学[M].2版.郑州:郑州大学出版社,2007:337.
[6]孟令哲,辛颖.儿童身材矮小的病因探讨[J].中国中西医结合儿科学,2015,7(3):203-207.
[7]雷巧容.重组人生长激素对身材矮小的小于胎龄儿身高的促增长作用[J].中外医学研究,2015,13(28):150-151.
[8]Tao S,Li G,Wang Q,et al.Efficacy and safety of human growth hormone in idiopathic short stature[J].Indian J Pediatr,2015,82(7):625-628.
[9]王伟,蔡丽霞,崔志瑞,等.特发性矮小患儿血中p53及p21waf/cip1的表达[J].郑州大学学报:医学版,2015,50(2):191-193.
[10]Nakanoh S,Fuse N,Tadokoro R,et al.Jak1/Stat3signaling acts as a positive regulator of pluripotency in chicken pre-gastrula embryos[J].Dev Bio,2017,421(1):43-51.
[2]Cohen LE.Idiopathic short stature:a clinical review[J].Jama,2014,311(17):1787-1796.
[3]区远赵,黄诚花,陈秀英,等.重组人生长激素治疗儿童生长激素缺乏症和特发性矮小症的安全性分析[J].中国实用医药,2017,12(13):87-89.
[4]Wit JM.Idiopathic short stature[J].J Cli Res Pediatr Endo,2015,7(1).22.
[5]栾斌.儿科学[M].2版.郑州:郑州大学出版社,2007:337.
[6]孟令哲,辛颖.儿童身材矮小的病因探讨[J].中国中西医结合儿科学,2015,7(3):203-207.
[7]雷巧容.重组人生长激素对身材矮小的小于胎龄儿身高的促增长作用[J].中外医学研究,2015,13(28):150-151.
[8]Tao S,Li G,Wang Q,et al.Efficacy and safety of human growth hormone in idiopathic short stature[J].Indian J Pediatr,2015,82(7):625-628.
[9]王伟,蔡丽霞,崔志瑞,等.特发性矮小患儿血中p53及p21waf/cip1的表达[J].郑州大学学报:医学版,2015,50(2):191-193.
[10]Nakanoh S,Fuse N,Tadokoro R,et al.Jak1/Stat3signaling acts as a positive regulator of pluripotency in chicken pre-gastrula embryos[J].Dev Bio,2017,421(1):43-51.