目的 探討賴氨酸磷酸氫鈣顆粒聯(lián)合重組人生長激素治療特發(fā)性矮小癥患兒的臨床療效。方法 選擇2018年8月—2019年8月在漯河市第三人民醫(yī)院治療的96例特發(fā)性矮小癥患兒，根據(jù)用藥差別分成對照組和治療組，每組各48例。對照組患者皮下注射重組人生長激素注射液，0.033～0.050 mg/kg，1次/d；治療組在對照組基礎(chǔ)上口服賴氨酸磷酸氫鈣顆粒，5 g/次，2次/d。兩組患者均經(jīng)12個月治療。觀察兩組患者臨床療效，比較治療前后兩組患者身高、體質(zhì)量、生長速度、骨齡，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）、25羥維生素D[25-（OH）D]、攝食抑制因子1（Nesfatin-1）、生長激素釋放肽（Ghrelin）、骨鈣素（OC）、Ⅰ型膠原交聯(lián)羧基末端肽（ICTP）、骨特異性堿性磷酸酶（BAP）和Ⅰ型前膠原氨基端前肽（PINP）水平。結(jié)果 經(jīng)治療，治療組總有效率明顯高于對照組（97.92% vs 83.33%，P<0.05）。治療后，兩組患兒身高、體質(zhì)量、生長速度、骨齡均明顯高于治療前（P<0.05），且治療組明顯高于對照組（P<0.05）。治療后，兩組血清IGF-1、IGFBP-3和25-（OH） D水平顯著升高，而Nesfatin-1和Ghrelin水平顯著降低（P<0.05），且治療組患者血清學(xué)指標(biāo)明顯好于對照組（P<0.05）。經(jīng)治療，兩組血清OC、ICTP、BAP、PINP水平均顯著升高（P<0.05），且治療組明顯高于對照組（P<0.05）。結(jié)論 賴氨酸磷酸氫鈣顆粒聯(lián)合重組人生長激素治療特發(fā)性矮小癥患兒可有效促進(jìn)患兒身高增長，促進(jìn)骨代謝指標(biāo)的改善，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical efficacy of Lysine Hydrochloride and Calcium Hydrogen Phosphate Granules combined with recombinant human growth hormone in treatment of idiopathic dwarfism in children. Methods Children (98 cases) with idiopathic dwarfism in Luohe Third People's Hospital from August 2018 to August 2019 were divided into control and treatment groups according to the difference of drugs, and each group had 48 cases. Children in the control group were hypodermic injection administered with Recombinant Human Growth Hormone Injection, 0.033 — 0.050 mg/kg, once daily. Children in the treatment group po administered with Lysine Hydrochloride and Calcium Hydrogen Phosphate Granules on the basis of the control group, 5 g/time, twice daily. Children in two groups were treated for 12 months. After treatment, the clinical efficacy was evaluated, and the height, weight, growth rate, and bone age, and serum levels of IGF-1, IGFBP-3, 25-(OH) D, Nesfatin-1, Ghrelin, OC, ICTP, BAP, and PINP in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was significantly higher than that of the control group (97.92% vs 83.33%, P<0.05). After treatment, the height, body mass, growth rate, and bone age in the two groups were significantly higher than those before treatment (P<0.05), and which in the treatment group were significantly higher than those in the control group (P<0.05). After treatment, the serum levels of IGF-1, IGFBP-3, and 25-(OH) D in two groups were significantly increased, while the levels of Nesfatin-1 and Ghrelin were significantly decreased (P<0.05), and these serological indexes in treatment group were significantly better than those in control group (P<0.05). After treatment, the serum levels of OC, ICTP, BAP, and PINP in two groups were significantly increased, and which in treatment group were significantly higher than those in control group (P<0.05). Conclusion Lysine Hydrochloride and Calcium Hydrogen Phosphate Granules combined with recombinant human growth hormone in treatment of idiopathic dwarfism in children can effectively promote children's height and improve the indexes of bone metabolism, which has a certain clinical application value.

R985

河南省醫(yī)學(xué)科技攻關(guān)計劃項目（20140516）