收稿日期: 2024-09-04
网络出版日期: 2025-03-20
基金资助
河北省医学科学研究重点课题计划项目(20210729);承德市科学技术研究与发展计划项目(201801A22)
Effect of lysine inositol vitamin B12 oral solution combined with rhGH on bone mineral density and insulin growth factor in children with idiopathic dwarfism
Received date: 2024-09-04
Online published: 2025-03-20
目的 观察赖氨肌醇维B12口服液联合重组人生长激素（rhGH）对特发性矮小症儿童骨密度、胰岛素样生长因子-1（IGF-1）的影响。 方法 选取收治的特发性矮小症患儿92例，采用随机数字表法分为两组。rhGH组采用0.15 U/kg·d剂量的rhGH治疗，综合组在rhGH基础上联合赖氨肌醇维B12口服液治疗。比较两组特发性矮小症患儿生长发育指标、IGF-1、骨代谢、血钙、血磷、维生素D水平，并统计两组特发性矮小症患儿不良反应。 结果 两组治疗前特发性矮小症患儿生长发育指标比较，差异无统计学意义（P > 0.05）。两组治疗12个月生长速度、身高标准差积分、体质量指数均较治疗前升高，综合组治疗12个月较rhGH组更高（P < 0.05）。两组治疗前特发性矮小症患儿IGF-1比较，差异无统计学意义（P > 0.05）。两组治疗6、12个月IGF-1均较治疗前升高，综合组治疗6、12个月较rhGH组更高（P < 0.05）。两组治疗前特发性矮小症患儿骨代谢、血钙、血磷、维生素D比较，差异无统计学意义（P > 0.05）。两组治疗12个月骨密度、骨碱性磷酸酶（BAP）、Ⅰ型前胶原氨基端前肽（PINP）、血钙、血磷、维生素D均较治疗前升高，综合组治疗12个月较rhGH组更高（P < 0.05）。综合组累计不良反应与rhGH组比较，差异无统计学意义（P > 0.05）。 结论 赖氨肌醇维B12口服液联合rhGH可改善特发性矮小症儿童改善骨代谢，促进生长发育。
关键词： 赖氨肌醇维B12口服液; 重组人生长激素; 特发性矮小症; 骨代谢; 生长发育
陈立娟 , 李斌 , 杨丽昕 . 赖氨肌醇维B12口服液联合rhGH对特发性矮小症儿童骨密度和胰岛素生长因子的影响[J]. 实用医学杂志, 2025 , 41(5) : 731 -735 . DOI: 10.3969/j.issn.1006-5725.2025.05.017
Objective To evaluate the effects of lysine inositol vitamin B12 oral solution in conjunction with recombinant human growth hormone （rhGH） on bone mineral density （BMD） and insulin-like growth factor-1 （IGF-1） levels in children with idiopathic short stature. Methods A total of 92 children diagnosed with idiopathic dwarfism at the Affiliated Hospital of Chengde Medical College between August 2021 and March 2024 were recruited and randomly divided into two groups using a random number table method. The rhGH group received recombinant human growth hormone （rhGH） at a dose of 0.15 U/kg/day， while the comprehensive treatment group received lysyl myo-inositol and vitamin B12 oral solution in addition to rhGH. Growth and development indices， IGF-1 levels， bone metabolism markers， serum calcium， serum phosphorus， and vitamin D levels were compared between the two groups. Additionally， adverse reactions were monitored and recorded for both groups. Results Comparison of growth and development indicators in children with idiopathic dwarfism before treatment between the two groups showed no significant difference （P > 0.05）. After 12 months of treatment， both groups exhibited increased growth rates， height standard deviation scores， and body mass indices compared to pre-treatment levels， with the combined group showing significantly higher values than the rhGH group （P < 0.05）. Similarly， there was no significant difference in IGF-1 levels between the two groups before treatment （P > 0.05）. However， at 6 and 12 months post-treatment， IGF-1 levels were significantly higher in both groups compared to baseline， with the combined group demonstrating significantly greater increases than the rhGH group （P < 0.05）. Regarding bone metabolism parameters， blood calcium， blood phosphorus， and vitamin D levels， no significant differences were observed between the two groups prior to treatment （P > 0.05）. At 12 months post-treatment， bone mineral density， bone alkaline phosphatase （BAP）， typeⅠprocollagen amino-terminal propeptide （PINP）， blood calcium， blood phosphorus， and vitamin D levels were significantly higher in both groups compared to pre-treatment levels， with the combined group showing significantly greater improvements than the rhGH group （P < 0.05）. Cumulative adverse effects did not differ significantly between the integrated group and the rhGH group （P > 0.05）. Conclusion The combination of lysine， inositol， vitamin B12 oral solution and rhGH enhances bone metabolism and promotes growth in children with idiopathic short stature.
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