42例儿童期起病的成人生长激素缺乏症的临床分析

doi:10.6040/j.issn.1671-7554.0.2015.309

山东大学学报（医学版） ›› 2015, Vol. 53 ›› Issue (10): 62-65.doi: 10.6040/j.issn.1671-7554.0.2015.309

42例儿童期起病的成人生长激素缺乏症的临床分析

罗雨萌¹, 阳洪波², 朱惠娟², 潘慧², 曾现伟¹

1. 潍坊医学院神经外科, 山东潍坊 261053;
2. 中国医学科学院北京协和医学院北京协和医院内分泌科, 卫生部内分泌重点实验室, 北京 100730

收稿日期:2015-03-23 出版日期:2015-10-10 发布日期:2015-10-10
通讯作者: 潘慧。E-mail:panhui20111111@163.com;曾现伟。E-mail:zengxwei@163.com E-mail:panhui20111111@163.com;zengxwei@163.com
基金资助:
国家自然科学基金(81400774);协和青年基金(33320140164)

Clinical analysis of 42 adults with childhood-onset adult growth hormone deficiency

LUO Yumeng¹, YANG Hongbo², ZHU Huijuan², PAN Hui², ZENG Xianwei¹

1. Department of Neurosurgery, Weifang Medical University, Weifang 261053, Shandong, China;
2. Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Key Laboratory of Endocrinology of The Ministry of Health, Beijing 100730, China

Received:2015-03-23 Online:2015-10-10 Published:2015-10-10

摘要/Abstract

摘要： 目的探讨儿童期起病的成人生长激素缺乏症(Co-AGHD)的病因分布、临床特点及治疗情况。方法回顾性分析2012年7月至2014年12月北京协和医院内分泌矮小门诊定期随诊的42例Co-AGHD患者出生情况、病因、临床特点、影像检查及治疗情况。根据是否接受重组人生长激素(rhGH)替代治疗,分为治疗组(n=12例)和未治疗组(n=30例),评价治疗效果。结果男性患者的比例高于女性。先天性病因39例,其中垂体发育不良20例,合并空泡蝶鞍3例,部分空泡蝶鞍1例,其他病因不详。获得性病因3例,均为颅咽管瘤术后患者。两组rhGH替代治疗在改善肝功能异常和血脂异常方面无明显差异(P>0.05)。结论 Co-AGHD病因多是先天性,其中大多患者出生史异常并伴有垂体发育不良。AGHD易合并多种代谢相关疾病。rhGH替代治疗在改善肝功能异常和血脂异常方面的有效性仍需进一步证实。

关键词: 代谢指标, 替代治疗, 成人生长激素缺乏症, 垂体发育不良, 重组人生长激素

Abstract: Objective To investigate the causes, clinical features and therapeutic effects of childhood-onset adult growth hormone deficiency (Co-AGHD). Methods Clinical data of 42 Co-AGHD patients (36 males and 6 females) treated in Nanism Clinic of Endocrinology Department of Peking Union Medical College Hospital during July 2012 and Dec. 2014 were retrospectively analyzed, including etiology, clinical features and therapeutic responses. According to whether they received recombinant human growth hormone(rhGH) therapy, the patients were divided into treatment group (n=12) and control group (n=30). The therapeutic effects were assessed. Results Among the 42 patients, the proportion of male was much higher than that of female. Congenital Co-AGHD was found in 39 cases: 20 with pituitary hypoplasia, 3 with empty sella syndrome, 1 with partially empty sella and the others with undefined causes. Acquired Co-AGHD was found in 3 cases which was induced by craniopharyngioma surgery. There was no significant difference between rhGH treatment group and control group in indexes of lipid and glucose (P>0.05). Conclusions Congenital etiology is the major cause of Co-AGHD, especially pituitary hypoplasia and empty sella syndrome. AGHD is linked to dyslipidemia, obesity and other metabolic diseases. Further studies and are needed to investigate the effects of rhGH replacement therapy on improvement of liver and lipid metabolism.

Key words: Adult growth hormone deficiency, Pituitary hypoplasia, Recombination human growth hormone, Replacement therapy, Metabolic index

中图分类号:

R584.2

罗雨萌, 阳洪波, 朱惠娟, 潘慧, 曾现伟. 42例儿童期起病的成人生长激素缺乏症的临床分析[J]. 山东大学学报（医学版）, 2015, 53(10): 62-65.

LUO Yumeng, YANG Hongbo, ZHU Huijuan, PAN Hui, ZENG Xianwei. Clinical analysis of 42 adults with childhood-onset adult growth hormone deficiency[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(10): 62-65.

参考文献

[1] Shimatsu A, Tai S, Tanaka T, et al. Clinical characteristics of Japanese adults with growth hormone deficiency:a HypoCCS database study[J]. Endocr J, 2011, 58(5):325-333.
[2] Mo D, Blum WF, Rosilio M, et al. Ten-year change in quality of life in adults on growth hormone replacement for growth hormone deficiency:an analysis of the hypopituitary control and complications study[J]. J Clin Endocrinol Metab, 2014, 99(12):4581-4588.
[3] Fukuda I, Hizuka N, Muraoka T, et al. Adult growth hormone deficiency:current concepts[J]. Neurol Med Chir (Tokyo), 2014, 54(8):599-605.
[4] Kim JH, Cho JH, Yoo HW, et al. Efficacy of growth hormone therapy in adults with childhood-onset growth hormone deficiency[J]. Ann Pediatr Endocrinol Metab, 2014, 19(1):32-35.
[5] Molitch ME, Clemmons DR, Malozowski S, et al. Evaluation and treatment of adult growth hormone deficiency:an Endocrine Society clinical practice guideline[J]. J Clin Endocrinol Metab, 2011, 96(6):1587-1609.
[6] Raben MS. Growth hormone. Clinical use of human growth hormone[J]. N Engl J Med, 1962, 266(1):82-86.
[7] Guo Q, Yang Y, Mu Y, et al. Pituitary stalk interruption syndrome in Chinese people:clinical characteristic analysis of 55 cases[J]. PLoS One, 2013, 8(1):535-79.
[8] Craft WH, Underwoood LE, Van Wyk JJ. High incidence of perinatal insult in children with idiopathic hypopituitarism[J]. J Pediatr, 1980, 96(3 Pt 1):397-402.
[9] Albertsson-Wikland K, Niklasson A, Karlberg P. Birth data for patients who later develop growth hormone deficiency:preliminary analysis of a national register[J]. Acta Paediatr Scand, 1990, 370 (suppl):115-120.
[10] Hamilton J, Blaser S, Daneman D. MR imaging in idiopathic growth hormone deficiency[J]. AJNR Am J Neuroradiol, 1998, 19:1609-1615.
[11] Guo Q, Yang Y, Mu Y, et al. Pituitary stalk interruption syndrome in Chinese people:clinical characteristic analysis of 55 cases[J]. PLoS One, 2013, 8(1):53579.
[12] Lange M, Muller J, Svendsen OL, et al. The impact of idiopathic childhood-onset growth hormone deficiency (GHD) on bone mass in subjects without adult GHD[J]. Clin Endocrinol (Oxf), 2005, 62(1):18-23.
[13] Bechtold S, Bachmann S, Putzker S, et al. Early changes in body composition after cessation of growth hormone therapy in childhood-onset growth hormone deficiency[J]. J Clin Densitom, 2011, 14(4):471-477.
[14] Quigley CA, Zagar AJ, Liu CC, et al. United States multicenter study of factors predicting the persistence of GH deficiency during the transition period between childhood and adulthood[J]. Int J Pediatr Endocrinol, 2013, 2013(1):6.
[15] Dichtel LE, Yuen KC, Bredella MA, et al. Overweight/Obese adults with pituitary disorders require lower peak growth hormone cutoff values on glucagon stimulation testing to avoid overdiagnosis of growth hormone deficiency[J]. J Clin Endocrinol Metab, 2014, 99(12):4712-4719.
[16] 岑晶, 顾锋. 成人生长激素缺乏症诊断与治疗指南解读[J]. 中国实用内科杂志, 2011, 31(8):603-612. CEN Jing, GU Feng. Interpretation of guidelines on the diagnosis and treatment of adults with growth hormone deficiency[J]. Chinese J of Practical Internal Medicine, 2011, 31(8):603-612.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed

42例儿童期起病的成人生长激素缺乏症的临床分析

Clinical analysis of 42 adults with childhood-onset adult growth hormone deficiency

PDF (PC)

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 2

多维度评价

本文评价

推荐阅读 0

[1]	叶瑞, 陈睿, 唐芳, 朱秋霞, 姜冬梅. 连续性肾脏替代治疗在60例危重症患者中的应用[J]. 山东大学学报（医学版）, 2014, 52(S2): 97-98.
[2]	黄艳,王旭霞,张文娟,刘超,张君 . 基因重组人生长激素（rh-GH）对大鼠牙周组织受正畸力后改建影响的实验研究[J]. 山东大学学报(医学版), 2007, 45(9): 899-902.