Abstract: Objective To study the efficacy of recombinant human growth hormone (rhGH) combined with letrozole on the improvement of the predicted final height in male children with adolescent idiopathic short stature (ISS). Methods Totally 60 male children diagnosed with adolescent idiopathic short stature admitted in Children's Hospital of Hebei Province from May 2015 to May 2019 were enrolled in this study and were divided into two groups by simple grouping method,with 30 cases in each group. The control group was treated with rhGH,while the experiment group was treated with rhGH and letrozole. Both groups were treated for one year. The improvement of physical development,growth rate,bone metabolism index and occurrence of adverse events were collected and analyzed. Results There were no significant differences in bone age,height and bone metabolism indexes between the two groups before treatment (P>0.05). After 1 year of treatment,the bone age and bone alkaline phosphatase(BALP) level of the experiment group were lower than those of the control group (t=6.537,9.290,P<0.05),and the levels of bone glaprotein(BGP),procollagen Ⅰ N-terminal peptide(PINP) and vitamin D of the experimental group were significantly higher than those of the control group (t=4.501,4.269,9.230,P<0.05). The predicted final height value was significantly higher in experiment group (t=2.833,P<0.05). There were no significant differences in growth rate and adverse reactions between the two groups (P<0.05). Conclusion Letrozole can improve the predicted final height of male children with adolescent idiopathic short stature.

Key words: idiopathic short stature, recombinant human growth hormone, letrozole, the predicted final height

摘要： 目的 研究青春期特发性矮小症男性患儿采用重组人生长激素联合来曲唑对改善其预测终身高的影响。方法 将河北省儿童医院2015年5月—2019年5月收诊的青春期特发性矮小症男性患儿60例,采用简单分组法分为两组,其中30例为对照组(采用rhGH治疗),另外30例为实验组(采用rhGH联合来曲唑治疗),两组患儿均治疗1年,收集分析两组患儿治疗期间体格发育、生长速率、骨代谢指标改善情况和不良事件发生情况。结果 两组患儿治疗前骨龄、身高、骨代谢指标差异无统计学意义(P＞0.05),治疗1年后,实验组患儿骨龄、骨碱性磷酸酶(BALP)含量低于对照组(t=6.537、9.290,P＜0.05),骨钙素(BGP)、Ⅰ型胶原氨基酸延长肽(PINP)、Vit-D含量明显高于对照组(t=4.501、4.269、9.230,P＜0.05);预测终身高明显高于对照组(t=2.833,P＜0.05),生长速率、不良反应发生率差异无统计学意义(P＞0.05)。结论 来曲唑可以改善青春期的特发性矮小症男性患儿的预测终身高。

关键词: 特发性矮小症, rhGH, 来曲唑, 预测终身高