重组人生长激素治疗特发性矮小疗效分析

目的：探讨基因重组人生长激素（recombinant human growth hormone,rhGH）对特发性矮小儿童促身高增长的疗效。方法：ISS儿童60例,每晚睡前接受rhGH治疗0.15-0.18 IU/（kg.d）,疗程3-9个月,并对其疗效进行观察。结果：ISS患儿经生长激素治疗后,生长速率明显增快,由治疗前4.21±0.36 cm/年提高到治疗后8.29±4.72 cm/年,差异有显著性（P〈0.05）。而骨龄和体重无明显变化,差异不显著（P〉0.05）。治疗期间除少数肝功能轻度异常,注射部位轻度反应外,未发现明显副作用。结论：rhGH对ISS儿童有增快生长速度作用。     

52例重组人生长激素治疗青春期前特发性矮小症儿童的护理

目的探讨重组人生长激素治疗青春前期特发性矮小症的护理方法。方法对52例青春前期特发性矮小症患儿的护理过程进行回顾性分析,总结重组人生长激素治疗青春前期特发性矮小症的护理方法。结果52例患儿经过治疗后,在身高增长的同时,不会使患儿的骨龄加快成长,不会使骨骺提前闭合,且无青春期提前的副反应,并且由于重组人生长激素治疗的剂量依赖方式改善了特发性矮小症儿童的身高增长速率和终身高。结论对青春前期特发性矮小症患儿在药物治疗的基础上再进行心理、睡眠、饮食、运动等方面的指导,有利于患儿的康复。     

特发性矮小患儿生长激素变化的研究

目的 探讨长春地区特发性矮小（ISS）患儿血中生长激素（GH）的变化及其与胰岛素样生长因子-1（IGF-1）和结合蛋白-3（IGFBP-3）的关系.方法 病例组为2009年-2012年长春市儿童医院内分泌科门诊确诊的ISS患儿201例,对照组为同期来院健康体检的儿童50例.所有研究对象均进行体格检查,骨龄测定和问卷调查,生长激素、IGF-1和IGFBP-3检测.结果 ISS患病率为48.09%;ISS患儿城乡比例为1.1∶1;骨龄延迟与HtSDS呈正相关;与正常对照组相比,ISS患儿GH基础值明显增高;ISS患儿GH基础值与IGF-1、IGFBP-3呈正相关;ISS患儿GH峰值与IGF-1水平无关;与IGFBP-3呈明显正相关.结论 ISS患儿可能存在GH受体不敏感导致GH水平升高;IGF-1、IGFBP-3高低可以反映机体GH水平,ISS患儿IGF-1、IGFBP-3降低可能是其发病的原因之一.     

矮身材患儿居家注射重组人生长激素依从性的研究进展

综述矮身材患儿居家注射重组人生长激素(recombinant human growth hormone,rhGH)依从性的研究现状、影响因素及干预措施。指出国内外矮身材患儿rhGH治疗依从性不容乐观,其依从性受到照护者文化水平、经济状况、注射装置、注射并发症及医患关系等的影响。加强对患儿及家属的健康教育,开展延续性护理措施,保持良好的医患沟通及运用先进的注射装置如电子注射笔等,都可有效提高其依从性。     

Recombinant human growth hormone therapy in HIV-associated wasting and visceral adiposity

This article reviews the clinical data on recombinant human growth hormone therapy of body composition abnormalities in HIV-infected patients. Short-term recombinant human growth hormone therapy at pharmacologic doses modestly increases total body weight and lean body mass in patients with HIV wasting, resulting in improvements in physical capacity and quality of life. Short-term recombinant human growth hormone therapy has a clear dose-dependent impact on trunk and visceral fat in HIV-infected patients with central fat accumulation, resulting in improvements in perception of body image and a beneficial effect on lipid parameters. Recombinant human growth hormone therapy is also accompanied by dose-dependent side effects related to fluid retention and increased insulin resistance. The optimal treatment strategy, maintenance dose and duration of treatment have not been identified.     

Immunoradiometric assay measurements of insulin-like growth factor-I (IGF-I): Comparison with radioimmunoassays using native or des (1–3) IGF-I as radioligands

Insulin-like growth-factor-binding proteins (BPs) in serum interfere with the measurement of insulin-like growth factor-I (IGF-I). Various assays have been developed to overcome this interference. We evaluated an immunoradiometric (IRMA) assay and compared it with the radioimmunoassay (RIA) using both native IGF-I and a truncated form of IGF-I [des (1–3) IGF-I] as radioligands. The IRMA was simpler (one step assay) and faster (3 hr incubation) than RIA(s) (overnight incubation). Sera were extracted with acid ethanol (AE) before all three assays. Analysis of serum samples (n = 78) performed by use of the two different radioligands in the RIA assays were highly correlated (r = 0.967, P < 0.0001). Measurements of serum IGF-I by IRMA in same samples were also highly correlated with those of the RIA assays (r = 0.952 for RIA and 0.947 for trIGF-I RIA, P < 0.0001 for both). To assess the effect of binding protein-3 (BP-3) levels (after AE extraction) on these assays, BP-3 levels were measured in sera from 36 healthy women. The mean BP-3 level was 3.6 ± 0.79 (S.D.) mg/L (range 1.3–5.0), and there was no significant difference in IGF-I levels measured by the three assays. Also, BP-3 levels were inversely correlated with IGF-I levels as measured by all three methods (r = 0.73 for IRMA, 0.71 for trIGF-I, and 0.75 for IGF-I RIA). To assess the effect of binding protein-1 (BP-1) levels on these assays, IGF-I was also measured by IRMA and trIGF-I RIA in 19 women with advanced breast cancer. Women with breast cancer had significantly higher (P < 0.001) BP-1 levels than age matched healthy women. IGF-I levels measured by IGF-I IRMA were slightly lower than those measured by trIGF-I RIA in breast cancer patients. However, this difference was not statistically significant (P = 0.56). These findings suggest that variations in BP-3 or BP-1 levels after AE extraction have no significant effect in any of these assays. We conclude that trIGF-I as a radioligand provides no added advantage over the standard IGF-I RIA. We also conclude that the IRMA assay is valid for measuring IGF-I and is faster and more convenient than RIA. © 1996 Wiley-Liss, Inc.     

基因重组人生长激素对严重烧伤后的康复作用

目的探讨基因重组人生长激素(rhGH)对蛋白质合成的影响及其在严重烧伤病人治疗中的作用.方法选择28例烧伤总面积>35%TBSA,III度面积>15%TBSA病人作为观察对象,随机分组,治疗组(rhGH组)15例和对照组13例.rhGH组病人术后每日由皮下按照0.2IU/kg.给予rhGH治疗共10d,对照组按相同方法给2ml生理盐水作安慰剂对照,伤后观察病人一般状况,测血常规、血生化、肝功(包括谷丙转氨酶ALT),植皮区、供皮区创面愈合时间及住院日期.结果rhGH治疗组供、植皮区创面愈合时间缩短,血浆总蛋白、白蛋白浓度提高,全身感染并发症例数减少,差异显著.结论rhGH可有效促进血浆蛋白质的合成,纠正机体负氮平衡,减少全身感染并发症、内脏并发症发生机会,促进创面愈合,缩短住院时间.     

重组人生长激素对慢性重型病毒性肝炎生长激素-胰岛素样生长因子轴的影响

目的研究重组人生长激素(rHGH)对慢性重型病毒性肝炎(chronic severe viral hepatitis,CSVH)患者生长激素(growth hormone,GH)-胰岛素样生长因子(insulin-like growth factor,GH-IGF)轴的变化以及其影响。方法CSVH患者25例(CSVH组),采用GH治疗,4.5 U/d,治疗前及治疗后,应用酶联免疫吸附(ELISA)法测定血清GH、胰岛素、胰岛素样生长因子1(IGF-1)、胰岛素样生长因子结合蛋白3(IGFBP-3),并以15例正常献血员为对照(正常对照组)。结果CSVH组治疗前血清GHI、GF-1I、GFBP-3、胰岛素的水平分别与正常对照组比较(5.50±4.21)μg/L vs(1.57±1.27)μg/L,(80.45±69.99)μg/L vs(172.97±78.12)μg/L,(109.93±87.53)μg/L vs(373.41±119.07)μg/L,(31.99±49.87)mg/L vs(6.72±1.09)mg/L,差异有统计学意义(P<0.05或P<0.001);存活的CSVH患者治疗后血清IGF-1I、GFBP-3的水平明显增加(P<0.05),GH、胰岛素水平有降低趋势,但差异无统计学意义。结论CSVH患者GH-IGF轴发生显著异常变化。初步的临床结果显示,rHGH治疗可缓解CSVH患者的GH抵抗状态及增加肝脏IGF-1I、GFBP-3的合成,并对改善患者的营养和代谢方面有重要意义。     

机械通气患者营养状况和免疫功能的变化及生长激素对其的影响

目的　观察机械通气患者的营养状况和免疫功能变化以及重组人生长激素 (rhGH)对其治疗作用。方法　 36例机械通气患者随机分为试验组 (rhGH组 ) 17例 ,对照组 19例 ,两组患者的营养支持方案相同 ,试验组予以rhGH 8U/d ,连续7d。观察两组患者各营养指标和免疫指标的变化结果。结果　两组患者治疗前营养状况和细胞免疫指标均低于正常。治疗3d后 ,试验组转为正氮平衡 (P <0 .0 5 ) ,同时前蛋白增加显著 (P <0 .0 1) ,CD3、CD4、CD8、CD4 /CD8比值增加明显 (P <0 .0 5 ) ;治疗 7d后 ,rhGH组血清蛋白和免疫指标较对照组改善明显 (P <0 .0 5 ,P <0 .0 1)。结论　营养支持联合rhGH能进一步改善机械通气患者的营养状况 ,同时对机体的免疫功能也有更好的调理作用。     

Simultaneous genotyping of human platelet antigens (HPA) 1 through 6 using new sequence-specific primers for HPA-5

BACKGROUND: Polymerase chain reaction using sequence-specific primers is widely used for genotyping human platelet antigens (HPA). However, the results of HPA-5 genotyping are still problematic. STUDY DESIGN AND METHODS: New sequence-specific primers were designed for HPA-5 that, together with already published primers, allow simultaneous genotyping of HPA-1, -2, -3, -4, -5, and -6. The reliability of the described protocol was determined by using reference DNA samples as well as samples from healthy blood donors. RESULTS: All primers produced specific amplification products.The genotype and the previously ascertained phenotype of the tested specimens were in concordance in all cases. CONCLUSION: The described polymerase chain reaction protocol allows rapid, reliable, simultaneous genotyping of HPA-1, -2, -3, -4, -5, and -6.     

Sensitivity and specificity of human T-lymphotropic virus (HTLV) types I and II polymerase chain reaction and several serologic assays in screening a population with a high prevalence of HTLV-II

BACKGROUND: Since 1988, all blood donations in the United States have been screened for antibodies to human T-lymphotropic virus type I (HTLV-I). However, the sensitivity of current serologic tests for the detection of HTLV type II (HTLV-II) antibodies and the diagnostic utility of direct tests for HTLV-I and -II using polymerase chain reaction (PCR) are poorly defined. STUDY DESIGN AND METHODS: Five hundred sixty-nine HTLV-I- or -II-seropositive and 687 age- and sex-matched seronegative samples from a high-risk population at an inner-city emergency department were selected. All samples were tested with four HTLV enzyme immunoassays (EIAs), one Western blot assay and one type-specific Western blot assay, one HTLV type-specific EIA, and a research HTLV-I/II PCR kit. RESULTS: Sensitivity of the various EIAs ranged from 95.1 to 99.5 percent, and specificity ranged from 97.2 to 99.4 percent. PCR performed in duplicate without selective retesting had lower sensitivity (85.1 %) and specificity (88.0%). However, PCR detected 20 (3.2%) HTLV-I-positive and 47 (7.5%) HTLV-II-positive samples among the 627 samples that were negative in all EIAs. The type-specific EIA and PCR assay had the highest rate of concordance in classifying samples as either HTLV-I or II, with the type-specific EIA and type-specific Western blot having the next highest rates of concordance. CONCLUSION: In this sample set from a population at high risk for HTLV-II, screening with HTLV-I/II PCR had lower sensitivity and specificity than that with EIAs. However, 4.1 to 10.8 percent of samples were PCR positive but seronegative for HTLV-I or -II, and their true infection status remains undetermined.