共查询到20条相似文献,搜索用时 15 毫秒
1.
To determine the effect of method of growth hormone (GH) administration on patient outcomes, we studied data from the GHMonitor, an electronic database registry of North American children treated with Saizen GH (somatropin [rDNA origin] for injection). Data from 631 children, 305 treated with needle and syringe and 326 treated with cool.click needle-free device, were analyzed. The groups were balanced for factors known to affect GH treatment response. There was no difference in response to GH over 2 years of treatment whether assessed by growth rate, change in height SD score, or change in height age. Although the majority of patients were compliant with GH therapy (84.6% of needle-free delivery system [NFDS] and 76.3% of needle and syringe patients missed <3 doses per month), significantly more patients using needle and syringe missed over one-half of their prescribed GH dose (13.4% needle and syringe patients versus 6% of NFDS patients, P=.002). In this group of poorly compliant patients, growth rates were significantly lower than in patients who missed fewer doses. Thus in patients where compliance is an issue, use of the NFDS may result in better outcomes. 相似文献
2.
An open-label acceptability study of Norditropin SimpleXx--a new liquid growth hormone formulation. 总被引:1,自引:0,他引:1
R Stanhope C Buchanan G Butler C Costigan D Dunger S Greene H Hoey I Hughes C Kelnar J Kirk J Komulainen M Lowry J Warner 《Journal of pediatric endocrinology & metabolism : JPEM》2001,14(6):735-740
A new liquid formulation of hGH (Norditropin SimpleXx) has been developed to avoid the need for reconstitution before administration. In addition, the liquid GH formulation has been combined with an advanced pen delivery system, either with or without a needle auto-insertion mechanism. This study was designed to assess the acceptability of the new system compared with the patient's previous system. A total of 103 children with GH deficiency received a daily injection of Norditropin liquid GH for 12 weeks with a choice of a pen/auto-insertion system. Acceptability was determined by nurse-supervised questionnaires administered to the patients and parents. Following treatment, 94% of patients preferred the Norditropin liquid GH system. This preference was irrespective of the previous system in use, patient age or length of GH therapy. More patients found it the less painful system (50% vs 13%), 92% of patients found it more convenient, and the formulation was well tolerated. In conclusion, Norditropin liquid GH was very well accepted and preferred by the majority of patients. It avoided reconstitution which had been a major cause of dissatisfaction with the patients' previous systems, and resulted in greater convenience and reduced levels of pain associated with injection. 相似文献
3.
Shinobu Ida Norikazu Yoshimura Mariko Nakacho Makiko Ota Hifumi Mine Hiroko Moriyama Naoko Terao Chikako Ueda Mariko Ohno 《Clinical Pediatric Endocrinology》2008,17(1):1-7
Pain resulting from needle injection is a serious problem for patients that
self-administer medication at home. We studied impressions of needle use by comparing
PenNeedle® 32G Taper (NovoFine® 32G Tip), developed to reduce the sense of fear and pain
of injection, with a conventional needle, in children self-injecting GH. A total of 34
patients self-injected themselves with needles coupled with Norditropin® NordiFlex®
pre-filled recombinant human GH, and impressions of use were evaluated by a series of
questionnaires. Compared to the conventional needle, PenNeedle 32G Taper was slightly less
painful at time of insertion according to patient responses, though the difference was not
statistically significant (P=0.06). PenNeedle 32G Taper has the same
inner diameter as the conventional needle, thus there was no difference in the pain felt
at time of injection between these two needles. Large differences in pain perception
between the two needles were not seen probably due to their similar shape and appearance
and as the subjects of this study were young. Nevertheless, based on the results of
post-study questionnaires, significantly more patients (68%, P=0.02)
expressed a desire to use PenNeedle 32G Taper for daily injections of GH. PenNeedle 32G
Taper thus appears to be a superior needle which reduces insertion-associated pain in
children receiving recombinant GH and improves patient QOL. 相似文献
4.
GH Verrips RA Hirasing M Fekkes T Vogels SP Verloove-Vanhorick HA Delemarre-Van de Waal 《Acta paediatrica (Oslo, Norway : 1992)》1998,87(2):154-158
The aim of the study was to test the hypothesis that daily administration of growth hormone using the Medi-Jector® results in fewer adverse psychological responses than needle injection with a multidose injection pen. The Medi-Jector is a needle-free injection device that can deliver growth hormone subcutaneously through jet injection. The group studied consisted of 18 children aged 10 y or over who were participating in a study of the bioequivalence and bioequipotence of the administration of growth hormone through jet injection or needle injection. Previously, all subjects had received growth hormone therapy with commercially available multidose injection pens. The study was designed as a prospective, randomized, two-period cross-over trial. A questionnaire was used to assess psychological responses such as non-compliance, opinion on ease of preparation, affective responses to administration and local side-effects, as well as overall preference. In addition, the subjects kept a diary during the study. The subjects found the Medi-Jector less offputting (p < 0:01), less painful with respect to both frequency (p <0.04) and intensity (p < 0.01) and less unpleasant (p < 0.05) than a multidose injection pen with a 28G needle (p <0.01). No difference in compliance was detected. Most subjects preferred the Medi-Jector for future use (p < 0.05). The mean score on a 1–10 point scale (10 is excellent) was 7.9 (SD 1.4) for the Medi-Jector and 6.8 (SD2.3) for the multidose injection pen (p <0.08). The prevalence of visible bruises each day was higher (p < 0.01) with the Medi-Jector (2.5, SD 2.1) than with the multidose injection pen (0.7, SD 1.1), but children showed indifferent affective responses to bruising. Thirteen out of 18 subjects decided to continue therapy with the Medi-Jector (p < 0.06). It is concluded that use of the Medi-Jector in growth hormone therapy tends to lead to fewer adverse psychological responses than a multidose injection pen with 28G needles. 相似文献
5.
K. ALBERTSSON-WIKLAND 《Acta paediatrica (Oslo, Norway : 1992)》1988,77(S343):103-106
For 30 years, GH deficient children have been treated with human GH. Earlier, therapy was given by intramuscular injections, but recently subcutaneous injections have been used. For the last few years, many children have been given daily injections, which have proved more effective. The form in which GH is supplied and administered entails taking an inconvenient hospital method into the daily family routine. The need to simplify the method of administration of GH has been fulfilled by a multidose vial for recombinant somatropin, developed to be used in an injection pen, the KabiPen. In the first clinical trial of 40 children, aged 2.5-21 years, all the families found the KabiPen to be much more convenient, less time-consuming, and easier when travelling; it also requires less space in the refrigerator and is easier for the child to handle. Most of the children found the KabiPen injections less painful, due to a finer and sharper needle and a smaller injection volume. Out of the 40 families, as many as 34 wanted to continue with the KabiPen after the 1-month trial. 相似文献
6.
OBJECTIVE: To determine the efficacy of a topical anesthetic cream, eutectic mixture of local anesthetics (EMLA), in alleviating pain associated with lumbar puncture in newborns. DESIGN: Randomized double-blind placebo-controlled trial. SETTING: Neonatal intensive care unit of a university teaching hospital.Patients Sixty consecutive newborns (gestational age, >or=34 weeks) undergoing diagnostic lumbar puncture.Intervention Topical application of 1 g of EMLA or placebo 60 to 90 minutes before lumbar puncture. MAIN OUTCOME MEASURES: Heart rate, transcutaneous oxygen saturation level, and total behavioral score recorded on a video camera and graded according to the Neonatal Facial Coding System. RESULTS: Compared with baseline, all newborns experienced pain as evidenced by increased heart rate, decreased oxygen saturation level, and total behavioral score (all within-groups differences were significant using repeated-measures analysis of variance; P<.001) during the procedure. Compared with placebo, EMLA significantly attenuated the pain response as shown by a lower mean +/- SE heart rate (per minute), particularly at needle insertion (EMLA: 159.3 +/- 2.3; placebo: 175.2 +/- 2.7; P<.001) and needle withdrawal (EMLA: 153.8 +/- 2.6; placebo: 167.3 +/- 2.5; P<.001), and a lower mean +/- SE total behavioral score, again at insertion (EMLA: 4.0 +/- 0.3; placebo: 5.0 +/- 0.0; P =.004) and withdrawal (EMLA: 1.8 +/- 0.3; placebo: 3.9 +/- 0.3; P<.001). There was no statistically significant difference between groups with regard to oxygen saturation level. CONCLUSIONS: Lumbar puncture in newborns produces pain responses. Eutectic mixture of local anesthetics is an efficacious agent for reducing the pain associated with needle insertion and withdrawal during lumbar puncture in newborns. 相似文献
7.
K Sjöblom K Albertsson-Wikland B-Å Bengtsson G Johannsson M Thorén M Degerblad MO Savage 《Acta paediatrica (Oslo, Norway : 1992)》1995,84(S411):63-65
The aim of this study was to evaluate patients'perception and acceptance of a new multi-dose injection device (Genotropina Pen) for recombinant growth hormone (GH) supplied in a two-chamber cartridge. The pen is combined with a very thin needle (B-D Microfine + (29 G) and meets future demands when dosing of GH will be changed from International Units (IU) to milligrams (mg). A total of 39 children receiving GH treatment (East Hospital, Gothenburg and St Bartholomew's Hospital, London), aged between 7 and 17 years, and 39 GH-treated adults (Sahlgrenska Hospital, Gothenburg and Karolinska Hospital, Stockholm), aged between 20 and 68 years, participated in the study. The daily dose ranged from 0.3 mg to 2.6 mg. The injections were given subcutaneously, once daily, and most of the patients used the thigh as an injection site. After a trial period of 2 weeks, injection technique, pain, fear of injection and convenience of the Genotropin® Pen were compared with the experience with the prestudy device (Genotropin KabiPena 16, 168 or 36) by questionnaire. A total of 95% of the patients preferred the Genotropin® Pen to the prestudy device for the following reasons: a greater certainty of correct dosing with the digital display;the possibility of correcting the set dose;the lock function of the injection button when injection is complete;more comfortable to hold due to the design and the plastic material;and reduced pain when injecting due to the thinner needles. Four patients (5%) preferred the prestudy device KabiPen® as they considered this to be 'good enough'. Thus, the Genotropin® Pen is a convenient injection device and most patients prefer it to the KabiPen®. 相似文献
8.
F de Zegher K Albertsson-Wikland P Wilton P Chatelain B Jonsson A Löfström O Butenandt J-L Chaussain 《Acta paediatrica (Oslo, Norway : 1992)》1996,85(417):27-31
A minority of children born small for gestational age (SGA) fail to achieve sufficient catch-up growth during infancy and remain short throughout childhood, apparently without being growth hormone (GH) deficient. The effect of GH administration was evaluated over 2 years in short prepubertal children born SGA. The children ( n = 244), who were taking part in four independent multicentre studies, had been randomly allocated to groups receiving either no treatment or GH treatment at a daily dose of 0.1, 0.2 or 0.3 IU/kg (0.033, 0.067 or 0.1 mg/kg) s.c. At birth, their mean length SD score (SDS) was -3.6 and their mean weight SDS -2.6; at the start of the study, mean age was 5.2 years, bone age 3.8 years, height SDS -3.3, height SDS adjusted for parental height -2.4, weight SDS -4.7 and body mass index (BMI) SDS -1.4. The untreated children had a low-normal growth velocity and poor weight gain. Although bone maturation progressed more slowly than chronological age, final height prognosis tended to decrease, according to height SDS for bone age. GH treatment induced a dose-dependent effect on growth, up to a near doubling of height velocity and weight gain; BMI SDS was not altered. Bone maturation was also accelerated differentially; however, final height prognosis increased in all GH treatment groups. The more pronounced growth responses were observed in younger children with a lower height and weight SDS. In conclusion, GH administration is a promising therapy for normalizing short stature and low weight after insufficient catch-up growth in children born SGA. Long-term strategies incorporating GH therapy now remain to be established. 相似文献
9.
Yutaka Igarashi 《Clinical Pediatric Endocrinology》2006,15(3):117-122
The aim of this study was to compare the therapeutic effects of rhGH administered either
by subcutaneous needle-injection (pens) or subcutaneous needle-free jet-injection
(VISION®). Furthermore, a survey was carried out after using
VISION® for 12 mo. A needle-free injection group consisting of 18 subjects
(11 males and 7 females, mean age 5.87 ± 2.05 yr at the start of hGH therapy) who have not
used pen injectors to date, were allowed to use VISION® in their third to fifth
years of GH therapy. In addition, a group of 8 subjects who had been using pen injectors
at our clinic (6 males and 2 females, mean age 6.54 ± 2.78 at the start of GH therapy) was
monitored as a control. The results indicate that there are no significant differences
between the mean growth rates, growth rate SD scores or height SD scores when comparing
injection devices. Furthermore, the survey of VISION® revealed that 70% of the
subjects found it slightly or not painful at or after injection, 70% found
VISION® very easy or easy to use, and 80% found the weight of the device
appropriate. All subjects expressed a desire to continue using VISION® in the
future. Our results suggest that there are no problems with the effectiveness of hGH
treatment with VISION®, a needle-free jet-injection device and that
VISION® is an effective device for children who have an aversion to needle
injection. 相似文献
10.
Hanas R 《Pediatric diabetes》2004,5(2):102-111
Most children and adolescents find the pain when injecting insulin quite minimal but still significantly more painful than a placebo injection. However, injection pain and needle phobia are major problems for a small number of patients, even after many years of diabetes. Needle diameter is of less importance for the experienced pain. The use of indwelling catheters (Insuflon, Unomedical, Lynge, Denmark) for introducing insulin injections at the onset of diabetes results in an evident relief of preinjection anxiety, injection problems, and the procedural pain of repeated injections. The average indwelling time is 3-5 d. Fixation problems and local redness at the insertion site are the most frequent side effects. However, the frequency is low and they can be dealt with effectively. Needles of 8-10 mm should be used for injecting to avoid penetration of the tubing of the catheter. Using indwelling catheters for up to 4-5 d does not affect the absorption of insulin, when the catheter is inserted in an area free from lipohypertrophies. The long-term (measured by hemoglobin A1c) and short-term metabolic control (measured by blood glucose profiles and serum-free insulin) is not altered. Using this type of injection aid may decrease the risk of future injection problems, such as needle phobia, in very select patients. In conclusion, indwelling catheters can safely be used from the onset of diabetes to lessen injection pain in children and adolescents, and may facilitate the use of intensive insulin therapy in this age group. 相似文献
11.
Aims: To investigate pain, leakage and bleeding when injecting insulin with different diameters of needles.
Methods: Sixty children and adolescents aged 9–21 yrs participated in study A and 40 aged 8–20 yrs in study B. Both were double-blind and randomized. In study A, we evaluated the pain when injecting with three needles [Novo 27G/13 mm (N27), B-D MicroFine IV 28G/13 mm (B28), NovoFine 28G/12 mm (N28)] and in study B, with three needles [NovoFine 28G/12 mm (N28), B-D MicroFine+ 29G/13 mm (B29), NovoFine 30G/8 mm (N30)] and one placebo injection (no needle mounted). Abdominal and thigh injections were given in a 45° angle with a lifted two-finger skinfold on two different visits, scoring pain on a 10-cm visual analog scale (VAS), and in study B faces were added to the scale.
Results: The median VAS scores in study A were 1.2 cm (N27), 1.2 cm (B28) and 1.0 cm (N28) for abdominal injections, and 1.2 cm (N27), 0.7 cm (B28) and 1.1 cm (N28) (n.s.) for thigh injections. The median VAS scores in study B were 2.5 cm (N28), 2.3 cm (B29) and 2.8 cm (N30) (n.s.) for abdominal injections, and 2.0 cm (N28), 1.5 cm (B29) and 1.9 cm (N30) (n.s.) for thigh injections. The overall median score of placebo injections was 0.1 cm (p=0.0001). Bleedings were less common with the B29 needle (35.5%) than with the N28 needle (48.1%) (p=0.028) but with no difference compared to the N30 needle (39.2%). Leakage of insulin was found in 14% of abdominal and 25% of thigh injections (p=0.0001) with no difference between the needles. VAS scores were higher in study B which may be explained by the facial VAS scale increasing the range of answers.
Conclusions: We found no difference in injection pain, preference, bleeding or insulin leakage between the needles. Decreasing the needle diameter from 0.4 to 0.3 mm (27–30G) does not seem to decrease pain perception in this age group. 相似文献
Methods: Sixty children and adolescents aged 9–21 yrs participated in study A and 40 aged 8–20 yrs in study B. Both were double-blind and randomized. In study A, we evaluated the pain when injecting with three needles [Novo 27G/13 mm (N27), B-D MicroFine IV 28G/13 mm (B28), NovoFine 28G/12 mm (N28)] and in study B, with three needles [NovoFine 28G/12 mm (N28), B-D MicroFine+ 29G/13 mm (B29), NovoFine 30G/8 mm (N30)] and one placebo injection (no needle mounted). Abdominal and thigh injections were given in a 45° angle with a lifted two-finger skinfold on two different visits, scoring pain on a 10-cm visual analog scale (VAS), and in study B faces were added to the scale.
Results: The median VAS scores in study A were 1.2 cm (N27), 1.2 cm (B28) and 1.0 cm (N28) for abdominal injections, and 1.2 cm (N27), 0.7 cm (B28) and 1.1 cm (N28) (n.s.) for thigh injections. The median VAS scores in study B were 2.5 cm (N28), 2.3 cm (B29) and 2.8 cm (N30) (n.s.) for abdominal injections, and 2.0 cm (N28), 1.5 cm (B29) and 1.9 cm (N30) (n.s.) for thigh injections. The overall median score of placebo injections was 0.1 cm (p=0.0001). Bleedings were less common with the B29 needle (35.5%) than with the N28 needle (48.1%) (p=0.028) but with no difference compared to the N30 needle (39.2%). Leakage of insulin was found in 14% of abdominal and 25% of thigh injections (p=0.0001) with no difference between the needles. VAS scores were higher in study B which may be explained by the facial VAS scale increasing the range of answers.
Conclusions: We found no difference in injection pain, preference, bleeding or insulin leakage between the needles. Decreasing the needle diameter from 0.4 to 0.3 mm (27–30G) does not seem to decrease pain perception in this age group. 相似文献
12.
Rose SR Baron J Bernstein D Yanovski J Troendle JF Leschek E Chipman J Cutler GB 《Journal of pediatric endocrinology & metabolism : JPEM》2000,13(3):281-288
OBJECTIVE: To identify the effect of exogenous GH on endogenous GH secretion in 48 non-GH deficient short children participating in a placebo-controlled trial of GH therapy on final adult height. DESIGN: Night GH secretion (mean of levels every 20 min from 20.00 to 08.00 h) was evaluated at baseline, 6 months before starting placebo or GH (somatotropin, 0.222 mg/kg/ week, divided into 3 doses each week). At 6 months after starting injections, blood samples for GH were obtained hourly for 24 h after an injection, and every 20 min on each of the next two nights (with no additional placebo or GH injection). RESULTS: IGF-I levels in the treatment group were elevated at 12 and 24 h but not at 36 h compared to the placebo group. Mean GH levels in the placebo group did not vary significantly among the four sampling periods. In the treatment group, the mean serum GH rose to a supraphysiological peak at an average time of 4 h after injection. Subsequently, mean GH level was significantly suppressed compared to placebo on the second night following GH injection, but returned to normal by the third night. CONCLUSION: After 6 months of a thrice weekly GH treatment regimen in non-GH deficient short children, endogenous GH secretion was reduced from 24 to 36 h after injection compared to placebo and returned to control levels by 48 to 60 h after injection. 相似文献
13.
Until recently the general regimen for treatment of growth hormone deficient (GHD) children consisted of 2 to 3 intramuscular (i.m.) injections per week using conventional syringes and vials. However, studies within the last 5–10 year have shown that by dividing the same total weekly dosage into daily subcutaneous (s.c.) injections it is possible to achieve a significantly increased growth rate. To make it more feasible for the patients and the parents to cope with this increased number of injections, an injection pen system (Nordiject) for administration of B-hGH has been developed. The Nordiject pen has been investigated both with respect to patient acceptance and bioavailablity of the B-hGH (Norditropin) injected with the device. Twenty-seven children with growth retardation were included in a study. The patients had no problems with the handling of the pen and approximately 2/3 of them experienced less injection pain with the pen compared to the syringe. Those patients who had previously been using conventional syringes strongly preferred the pen, and all wished to continue using the device.Fourteen adult GHD patients were included in a randomized cross-over study for investigation of bioavailability. Two separate s.c. injections of 4 IU of B-hGH (Norditropin) each were administered in random order by means of either syringe (4IU/ml) or injection pen (Nordiject) (12 IU/ml). On the basis of this study it was concluded that the bioavailability of B-hGH, measured as AUC, C max′ and t max′ is equal following injection with the pen to that of injection by syringe. 相似文献
14.
M. HERMANUSSEN K. GEIGER-BENOIT J. BURMEISTER W.G. SIPPELL 《Acta paediatrica (Oslo, Norway : 1992)》1988,77(S343):202-207
Based on the hypothesis of periodical refractoriness of the growing tissue to exogenous administration of GH, an experimental approach is presented in which the dosage of GH was adjusted to the natural occurrence of periodical changes of the lower leg growth velocity in five children with short stature. Two 6-month periods were compared, during which the children received an identical cumulative dose of GH of 224 IU/m2 . During the first period, the children received a constant GH dose of 14 IU/m2 /week by daily subcutaneous injection, whereas a low/high dose alternation was administered at approximately 3-week intervals synchronously with the occurrence of mini growth spurts during the second 6-month period. In all the children, mean linear growth of the lower leg accelerated during the period of synchronization by 595% compared to the previous growth rate during constant GH administration. 相似文献
15.
The use of optimum conventional growth hormone administration, using a growth hormone vial combined with an Auto Injector, was compared with a pen injection system using a cartridge of growth hormone. In both methods of administration the concentration of growth hormone was 16 IU/ml. Thirty patients (22 boys, eight girls) who had all previously been treated with growth hormone (4 IU/ml) administered using needles and syringes (without an Auto Injector) were randomised into receiving one of either treatment for three months and then crossed over for a further three months. Fourteen patients (10 boys, four girls) initially received KabiVial 16 IU/ml combined with an Auto Injector while 16 patients (12 boys, four girls) were treated with KabiPen 16 IU/ml. Mean age in both groups was 9.6 years. The majority of patients in both groups were treated with a regimen of either 15 or 20 units/m2/week as a daily subcutaneous injection. Of the 30 patients who started in this trial, two who commenced using an Auto Injector refused to change to a pen system and were excluded from further analysis. When scored on a scale of -5 to +5 general convenience when changing from an Auto Injector to the KabiPen decreased from +4.7 to +1.0. When assessed for pain, the Auto Injector group scored +4.7, which decreased to -0.2 (more painful) for the pen. At the end of the trial 23 patients (82%) chose to continue with the KabiVial/Auto Injector combination as they found this less painful and the child did not see the needle or need to insert the needle manually. Five patients (18%) continued with the KabiPen as they considered the device smaller and easier to use. The accuracy of dosing using KabiVial was 100% compared with the range of 88% to 111% using KabiPen as the latter was available only in 0.5 unit increments. No growth hormone was wasted using KabiVial, although a mean of 0.6 units was wasted with every 16 IU cartridge in the KabiPen system. It is concluded that patients should be able to contribute to the choice of growth hormone delivery systems and that newer methods need careful assessment. 相似文献
16.
Toshiaki Tanaka Tomonobu Hasegawa Keiichi Ozono Hiroyuki Tanaka Susumu Kanzaki Susumu Yokoya Kazuo Chihara Noriyuki Iwamoto Yoshiki Seino 《Clinical Pediatric Endocrinology》2014,23(3):83-92
The aim of this study was to assess changes in quality of life (QoL) in Japanese children
with GH deficiency (GHD) after 12 mo of GH treatment or with idiopathic short stature
(ISS) after 12 mo without treatment. Children with GHD were treated with GH after
enrollment. Outcome measures included the parent-rated Child Behavior Checklist (CBCL),
the Youth Self-Report Form (YSR), and height standard deviation scores (SDS). Total CBCL
scores significantly decreased in children with GHD (n = 152, mean change (standard
deviation [SD]) = –3.42 [11.21]) and ISS (n = 129, mean change = –4.82 [10.09]) after 12
mo (p < 0.001). Total YSR scores (mean change = –9.21 [14.07]) and height SDS (mean
change = 0.35 [0.38]) significantly decreased in children with GHD (p < 0.001), but
were unchanged in children with ISS. The change in total YSR score was significantly
correlated with the change in height SDS in children with GHD (r = –0.516, p = 0.003). Our
findings demonstrate that GH treatment can improve QoL in Japanese children with GHD. The
correlation between the changes in total YSR score and height SDS demonstrated that
increased height resulted in improved QoL. 相似文献
17.
C H Albini T Quattrin B Mills B Sherman A Johanson M H MacGillivray 《Clinical pediatrics》1992,31(9):542-545
Urinary growth hormone (GH) and insulin-like growth factor I (IGF-I) excretion profiles were compared in children receiving biosynthetic GH. Group 1 included 18 healthy controls. Group 2 included nine children given biosynthetic GH three times a week. Group 3 included 14 children given daily GH injections. Overnight urine samples were collected for three consecutive nights in all groups. No significant day-to-day variation in urinary GH output was observed in group 1. In group 2, urinary GH output was significantly higher on day one following injection than on days two and three. Urine GH outputs in group 2 were significantly lower on days two and three than the values observed on all days in group 3. Throughout the three-day study, subjects in group 3 excreted similar amounts of GH significantly higher than those of controls. Urinary IGF-I output (nmol/kg) was similar on all three study days in groups 1 and 3. Group 2 had significantly lower urinary IGF-I output on day three compared with day one. Urinary IGF-I output on day three was also significantly lower in group 2 than in group 3. We conclude that urinary GH and IGF-I outputs are influenced by the frequency of GH administration. 相似文献
18.
Modulation of glucocorticoid secretion by growth hormone 总被引:1,自引:0,他引:1
We measured the cortisol and corticosterone responses to insulin-induced hypoglycemia in 13 growth hormone (GH)-deficient children and 30 short children without GH deficiency. Although there was no difference between the two groups in degree of hypoglycemia attained, baseline cortisol, baseline corticosterone, or cortisol 40 min after insulin injection, GH-deficient children had a significantly greater corticosterone response to this stress (3.6 +/- 0.4 versus 1.9 +/- 0.2 micrograms/dl). (All data are presented as mean +/- SEM.) In order to explore the effect of GH on corticosterone secretion, we measured cortisol and corticosterone responses to synthetic (1-24) ACTH before and after 3 days of exogenous GH (0.2 unit/kg/day). In 13 GH-deficient children, GH treatment caused a significant decrease in the corticosterone response to ACTH (2.2 +/- 0.2 micrograms/dl before GH to 1.6 +/- 0.2 micrograms/dl; t = 5.22, p less than 0.001; paired t test) despite the fact that there was no significant change in the cortisol response to ACTH (18 +/- 2 micrograms/dl before and 16 +/- 2 micrograms/dl after). When seven short children who were not GH deficient underwent a similar 3-day course of GH, the decrease in their corticosterone response was much less although still statistically significant (2.0 +/- 0.5 to 1.8 +/- 0.5 micrograms/dl; paired t test, p less than 0.05). Again, the stimulated levels of cortisol were not affected by GH treatment (19 +/- 4 versus 18 +/- 3 micrograms/dl) These results indicate that GH modulates the adrenal response to ACTH by suppressing corticosterone secretion without affecting cortisol secretion. In summary, this study presents two new findings.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
19.
M Phillip E Hershkovitz O Belotserkovsky E Leiberman Y Limoni Z Zadik 《Acta paediatrica (Oslo, Norway : 1992)》1998,87(5):518-520
The aim of this study was to compare the growth response of 22 short pre-pubertal children without growth hormone deficiency, treated with a single daily growth hormone injection (group A), to the growth response of 27 similar children, treated with the same daily dose divided into 2 subcutaneous injections per day (group B), for 1 y, in a randomized study. GH treatment significantly promoted growth parameters, height standard deviation score and height velocity standard deviation score in both groups. Serum insulin-like growth factor I was also increased. There were no significant differences in growth response, serum IGF-I levels, or the advance in bone age between the two study groups after 1 y of GH therapy. We conclude that twice daily s.c. growth hormone injections provide no advantages over once daily injection of the same dose in promoting the linear growth of short children without growth hormone deficiency. 相似文献
20.
Very preterm infants developing bronchopulmonary dysplasia frequently show a compromised growth in the neonatal period especially when steroids are given to facilitate weaning from the ventilator. The aim of this study was to evaluate the short-term effect of dexamethasone (DEXA) on the GH-IGF axis in ventilated very preterm infants developing bronchopulmonary dysplasia. We studied 10 very preterm artificially ventilated infants with bronchopulmonary dysplasia [median (range) gestational age 27.5 wk (25.9-32.0 wk), median (range) birth weight 970 g (610-2150 g)] immediately before and 2 d after the start of DEXA treatment. On both days of study, serum GH profiles were obtained, and serum IGF-I and IGF binding protein (IGFBP) -1 and -3 levels were measured. The ventilation score and the nutritional intake were calculated. Before the start of DEXA treatment, the median serum mean GH level was 12.0 microg/L (6-28.4 microg/L), whereas 2 d after the start of DEXA treatment the median serum mean GH level declined significantly to a value of 4.4 microg/L (1.7-11.9 microg/L). During DEXA treatment, mean, baseline, and maximal GH levels (Pulsar analysis) were significantly lower compared with pretreatment levels (p < 0.01, p < 0.01, and p < 0.05, respectively). Serum IGF-I and IGFBP-3 levels did not decline during DEXA. Serum IGFBP-1 levels were significantly lower compared with pretreatment levels (p < 0.01). Serum GH levels during DEXA treatment were correlated with neither the time interval between the administration of DEXA and the second GH profile nor the cumulative DEXA dose administered. Ventilation score and nutritional intake did not significantly correlate with serum GH, IGF-I, or IGFBP-1 or -3 levels, either before or after the start of DEXA. Two days of DEXA treatment in very preterm ventilated infants has a suppressive effect on serum GH levels, without an acute decline in serum IGF-I levels. A concomitant decrease in serum IGFBP-1 levels was found. 相似文献